Individual provider Active NPI

Ariella Jeanine Garmizo

  • Physician Assistant
  • Port St Lucie, FL
National Provider Identifier
1073115184
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113788 Issued in FL
Practice address
8980 S US Highway 1 Ste 103
Port St Lucie, FL 34952-3482
Phone
(561) 406-9566
NPI assigned
Nov 13, 2020
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA9113788 FL Primary

Addresses

Primary practice location

8980 S US Highway 1 Ste 103
Port St Lucie, FL 34952-3482

Mailing address

404 SW Sandy Way
Port St Lucie, FL 34986-2084
Phone (954) 803-1156

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
I20201117002055 FL Practitioner - Physician Assistant 0446661748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Beach DermatologyGroup PAC ID 6709864218, 19 clinicians

Practice addresses (Care Compare)

4495 Military TRL
Suite 204
Jupiter, FL 33458-4818
Phone (561) 296-1122

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: agarmizo@myskindoc.emadirect.md

Organizations & group practices 1

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": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1073115184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 SW SANDY WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862084",
            "telephone_number": "954-803-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8980 S US HIGHWAY 1 STE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523482",
            "telephone_number": "561-406-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARMIZO",
        "first_name": "ARIELLA",
        "middle_name": "JEANINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.