Individual provider Active NPI

Ekaterina Page

  • Physician Assistant
  • Miramar Beach, FL
National Provider Identifier
1073269775
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
APRN11018111 Issued in FL
Practice address
7720 US Highway 98 W
Ste 110
Miramar Beach, FL 32550
Phone
(850) 267-1603
NPI assigned
Feb 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 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 APRN11018111 FL Primary

Addresses

Primary practice location

7720 US Highway 98 W
Ste 110
Miramar Beach, FL 32550

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

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
I20220425002466 FL Practitioner - Nurse Practitioner 7315334174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

7720 US Hwy 98 W
Suite 110
Miramar Beach, FL 32550-7232
Phone (850) 267-1603

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Apr 18, 2022 Accepting new patients
Sacred Heart Health System Inc CurrentSince Apr 18, 2022 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

7720 US Highway 98 W
Ste 110
Miramar Beach, FL 32550
Phone (850) 267-1603

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Interoperability endpoints

  • Direct secure messaging: ekaterina.page.1@9582.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1073269775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 US HIGHWAY 98 W",
            "address_2": "STE 110",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "32550",
            "telephone_number": "850-267-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "EKATERINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "APRN11018111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar Beach, FL

Sources for this page

Verify at the official NPI Registry.