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

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

Practice roles (1 of 2)

Locations

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 and National Provider Directory roles.

• Sterling Emergency Services of Florida PA

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

  FL

  Medicare reassignment
• Sterling Emergency Services of Florida PA

  • Emergency Medicine Physician
  • Boynton Beach, FL
  • NPI 1578814570

  Physician Assistant

  NPD

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

• All providers in Riviera Beach, FL
• 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.