Reginald Denizard, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103579 Issued in FL

Practice address

7305 N Military TRL
Riviera Beach, FL 33410-7417

Phone

(561) 422-7589

NPI assigned

Mar 10, 2006

Last updated

Mar 7, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sterling Emergency Services of Florida PA

  • Emergency Medicine Physician
  • West Palm Beach, FL
  • NPI 1295720241
  Medicare reassignment

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1164490686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4363 HUNTING TRL",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334673505",
            "telephone_number": "561-723-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 N MILITARY TRL",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334107417",
            "telephone_number": "561-422-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIZARD",
        "first_name": "REGINALD",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romana Decebal
• Dedicated Senior Medical Center of Florida, LLC
• Beth Dejongh, PHARM.D.
• Victoria Melissa Delcorto
• Barbara Rose Denicola, N.P.
• Department of Veterans Affairs
• Department of Veterans Affairs Medical Center West Palm Beach
• Department of Veterans Affiars
• Dependable Medical Equipment LLC
• Dept of Veterans Affairs Medical Center

• Physician Assistant in Riviera Beach, FL
• Providers in Riviera Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.