Individual provider Active NPI

Mauricio Zuluaga, PA-C

  • Physician Assistant
  • Lake Worth, FL
National Provider Identifier
1063128460
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117007 Issued in FL
Practice address
238 Fordham Dr
Lake Worth, FL 33460-6219
Phone
(561) 929-3626
NPI assigned
Jan 30, 2023
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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 PA9117007 FL Primary

Addresses

Primary practice location

238 Fordham Dr
Lake Worth, FL 33460-6219

Mailing address

238 Fordham Dr
Lake Worth, FL 33460-6219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230403002360 FL Practitioner - Physician Assistant 7315312436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

11800 S Military TRL
Suite 105
Golf, FL 33436-5506
Phone (561) 264-2280

14701 S Military TRL
Delray Beach, FL 33484-8152
Phone (561) 865-4702

1625 S Federal Hwy
Boynton Beach, FL 33435-6953
Phone (561) 945-0544

2181 N Federal Hwy
Boca Raton, FL 33431-7707
Phone (561) 387-3500

2272 N Congress Ave
Boynton Beach, FL 33426-8604
Phone (561) 737-1927

2606 S Dixie Hwy
West Palm Beach, FL 33401-7920
Phone (561) 804-4327

4570 Lantana Rd
Lake Worth, FL 33463-6908
Phone (561) 963-9881

6699 W Boynton Beach Blvd
Boynton Beach, FL 33437-3527
Phone (561) 734-4210

9690 Glades Rd
Unit 425
Boca Raton, FL 33434-4015
Phone (561) 449-2322

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9117007FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Jan 29, 2024 Accepting new patients

Locations

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1063128460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 FORDHAM DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334606219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 FORDHAM DR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334606219",
            "telephone_number": "561-929-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZULUAGA",
        "first_name": "MAURICIO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-30",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.