Individual provider Active NPI

Samelien Fineus, P.A.

  • Physician Assistant
  • Lauderhill, FL
National Provider Identifier
1063041796
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9207 Issued in AZ
Practice address
4300 NW 19TH St Apt I401
Lauderhill, FL 33313-7336
Phone
(954) 701-9264
NPI assigned
Apr 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9207 AZ Primary

Addresses

Primary practice location

4300 NW 19TH St Apt I401
Lauderhill, FL 33313-7336

Mailing address

4300 NW 19TH St Apt I401
Lauderhill, FL 33313-7336
Phone (954) 701-9264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221008000254 AZ Practitioner - Physician Assistant 5991181364 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Masters Mobile Physicians, PCGroup PAC ID 4082013982, 3 clinicians

Practice addresses (Care Compare)

Tempe, AZ 85283
Phone (520) 479-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1063041796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 NW 19TH ST APT I401",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333137336",
            "telephone_number": "954-701-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 NW 19TH ST APT I401",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333137336",
            "telephone_number": "954-701-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINEUS",
        "first_name": "SAMELIEN",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-04",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

Verify at the official NPI Registry.