Individual provider Active NPI

Sylvia Marie Vives-Montano, PA-C

  • Medical Physician Assistant
  • Miami, FL
National Provider Identifier
1114168044
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104725 Issued in FL
Practice address
11400 N Kendall Dr Ste 204
Miami, FL 33176-1029
Phone
(305) 279-4222
NPI assigned
Mar 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104725 FL Primary

Addresses

Primary practice location

11400 N Kendall Dr Ste 204
Miami, FL 33176-1029

Mailing address

11400 N Kendall Dr Ste 204
Miami, FL 33176-1029
Phone (305) 279-4222

Other practice location 1

9851 NW 58th St Unit 109
Doral, FL 33178-2717
Phone (305) 470-9002

Other identifiers 1

IdentifierTypeStateIssuer
PA9104725OtherFLPHYSICIAN ASSISTANT LICENSE NUMBER

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
I20110201000897 FL Practitioner - Physician Assistant 9537349931

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Juan a Mantilla MD PA CurrentSince Jun 27, 2021 Accepting new patients
Value Healthcare Partners PastSince Dec 1, 2024 Accepting new patients

Locations

11400 N Kendall Dr
Ste 204
Miami, FL 33176
Phone (305) 279-2222

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBFFCD/Endpoint/JBFFCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/JBFFCD

Organizations & group practices 2

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": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1114168044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 N KENDALL DR STE 204",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761029",
            "telephone_number": "305-279-4222",
            "fax_number": "305-501-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 N KENDALL DR STE 204",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761029",
            "telephone_number": "305-279-4222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9851 NW 58th St Unit 109",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "331782717",
            "country_code": "US",
            "telephone_number": "305-470-9002",
            "fax_number": "305-470-9934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIVES-MONTANO",
        "first_name": "SYLVIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE NUMBER",
            "identifier": "PA9104725",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.