Individual provider Active NPI

Cynthia Van

  • Physician Assistant
  • Miami Shores, FL
National Provider Identifier
1073366795
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11300 NE 2ND Ave
Miami Shores, FL 33161-6628
Phone
(305) 899-3000
NPI assigned
Apr 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 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 Primary

Addresses

Primary practice location

11300 NE 2ND Ave
Miami Shores, FL 33161-6628

Mailing address

11300 NE 2ND Ave
Miami Shores, FL 33161-6628

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
I20240920001273 FL Practitioner - Physician Assistant 9739620576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Barry University School of Podiatric Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSMC Interventional, LLCGroup PAC ID 2264686443, 11 clinicians
Neurosurg LLCGroup PAC ID 2860412509, 15 clinicians

Practice addresses (Care Compare)

4300 Alton Rd
Miami, FL 33140-2948
Phone (305) 674-2071

4302 Alton Rd
Suite 810
Miami Beach, FL 33140-2893
Phone (305) 674-2950

4306 Alton Rd
2ND FL
Miami Beach, FL 33140-2800

Hospital & facility affiliations

  • Mount Sinai Medical Center of Florida, Inc Hospital, Miami Beach, FL, CCN 100034

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MSMC Interventional, LLC Past Accepting new patients

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 1

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": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1073366795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 NE 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331616628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 NE 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331616628",
            "telephone_number": "305-899-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "CYNTHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

Verify at the official NPI Registry.