Individual provider Active NPI

Joanna Difalco, PA-C

  • Physician Assistant
  • Boynton Beach, FL
National Provider Identifier
1164830352
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117257 Issued in FL
Practice address
2800 S Seacrest Blvd Ste 200
Boynton Beach, FL 33435-7966
Phone
(732) 668-5797
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 PA9117257 FL Primary

Addresses

Primary practice location

2800 S Seacrest Blvd Ste 200
Boynton Beach, FL 33435-7966

Mailing address

115 Hawthorne Ave
Neptune City, NJ 07753-6337
Phone (732) 668-5797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220510000278 NY Practitioner - Physician Assistant 7719364942 Reassigns benefits to 1 organization
I20231208002013 FL Practitioner - Physician Assistant 7719364942 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017616NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Nov 13, 2023 Accepting new patients
Holy Cross Hospital Inc CurrentSince Nov 13, 2023 Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

Interoperability endpoints

  • Direct secure messaging: jdifalco3150217@direct.trinity-health.org

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1164830352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HAWTHORNE AVE",
            "city": "NEPTUNE CITY",
            "state": "NJ",
            "postal_code": "077536337",
            "telephone_number": "732-668-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S SEACREST BLVD STE 200",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357966",
            "telephone_number": "732-668-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFALCO",
        "first_name": "JOANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.