Individual provider Active NPI

Marie Yves Vales-Preval, PA-C

  • Physician Assistant
  • Oakland Park, FL
National Provider Identifier
1124051875
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103470 Issued in FL
Practice address
2901 W Oakland Park Blvd
Suite A4
Oakland Park, FL 33311-1243
Phone
(954) 484-9590
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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 PA9103470 FL Primary

Addresses

Primary practice location

2901 W Oakland Park Blvd
Suite A4
Oakland Park, FL 33311-1243

Mailing address

2901 W Oakland Park Blvd
Suite A4
Oakland Park, FL 33311-1243
Phone (954) 484-9590

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
I20111003000157 FL Practitioner - Physician Assistant 3678745338 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9103470FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tu Salud Optimal Care LLC CurrentSince Mar 19, 2024 Accepting new patients
Hospitalis10 Inc PastSince Jan 21, 2022 Accepting new patients
Mendez Eyes Optical LLC PastSince Jun 9, 2024 Accepting new patients

Interoperability endpoints

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

Organizations & group practices 4

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1124051875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W OAKLAND PARK BLVD",
            "address_2": "SUITE A4",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111243",
            "telephone_number": "954-484-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W OAKLAND PARK BLVD",
            "address_2": "SUITE A4",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111243",
            "telephone_number": "954-484-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALES-PREVAL",
        "first_name": "MARIE",
        "middle_name": "YVES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

Verify at the official NPI Registry.