Individual provider Active NPI

Alexandra Majesty, P.A.

  • Physician Assistant
  • Stuart, FL
National Provider Identifier
1134429665
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9111171 Issued in FL
Practice address
2220 SE Ocean Blvd Ste 301
Stuart, FL 34996-3301
Phone
(772) 220-3339
Fax
(772) 286-2635
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0010-03505 NC
Physician Assistant 363A00000X 4703 AZ
Physician Assistant 363A00000X 017303 NY
Physician Assistant 363A00000X 22939 CA
Medical Physician Assistant 363AM0700X 0010-03505 NC
Physician Assistant 363A00000X 9111171 FL Primary

Addresses

Primary practice location

2220 SE Ocean Blvd Ste 301
Stuart, FL 34996-3301

Mailing address

2220 SE Ocean Blvd Ste 301
Stuart, FL 34996-3301
Phone (772) 220-3339

Other practice location 1

477 N El Camino Real
C204
Encinitas, CA 92024-1328
Phone (760) 634-3376

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
I20180906002222 FL Practitioner - Physician Assistant 4880870955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017303NYMDPsychologist
22939CAMDPediatric Dentist
9111171FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Waterside Dermatology and Laser Center PLLC Dermatology Past Accepting new patients
Schenectady Dermatology, PC Dermatology PastSince Jun 16, 2006 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2216/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1134429665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 SE OCEAN BLVD STE 301",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349963301",
            "telephone_number": "772-220-3339",
            "fax_number": "772-286-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 SE OCEAN BLVD STE 301",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349963301",
            "telephone_number": "772-220-3339",
            "fax_number": "772-286-2635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "477 N El Camino Real",
            "address_2": "C204",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920241328",
            "country_code": "US",
            "telephone_number": "760-634-3376",
            "fax_number": "760-634-7955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAJESTY",
        "first_name": "ALEXANDRA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "0010-03505",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4703",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017303",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22939",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03505",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.