Individual provider Active NPI

Mary-Ann Girgis, P.A.-C

  • Physician Assistant
  • Fort Pierce, FL
National Provider Identifier
1063630994
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9105577 Issued in FL
Practice address
1700 S 23Rd St
Fort Pierce, FL 34950-4803
Phone
(772) 461-4000
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04411 TX
Physician Assistant 363A00000X PA 9105577 FL Primary

Addresses

Primary practice location

1700 S 23Rd St
Fort Pierce, FL 34950-4803

Mailing address

1617 N Flagler Dr
Uph 1202
West Palm Beach, FL 33407-6537
Phone (561) 351-0991

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
I20110620000485 FL Practitioner - Physician Assistant 7113106337 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9105577FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Oct 1, 2012 Accepting new patients
Sterling Emergency Services of Florida PA Physician Assistant CurrentSince Apr 9, 2012 Accepting new patients
Florida Em-I Medical Services, PA Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients
Florida Em-I Medical Services, PA Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients
Sterling Emergency Services of Florida PA Physician Assistant CurrentSince Apr 9, 2012 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Oct 1, 2012 Accepting new patients
Nicklaus Children'S Pediatric Specialists, LLC Past Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

17240 Cortez Blvd
Brooksville, FL 34601
Phone (352) 544-6060

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

Organizations & group practices 8

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1063630994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 N FLAGLER DR",
            "address_2": "UPH 1202",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334076537",
            "telephone_number": "561-351-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S 23RD ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504803",
            "telephone_number": "772-461-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRGIS",
        "first_name": "MARY-ANN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04411",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9105577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.