Laura Charlotte Valeri Pedoussaut, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAT9111939 Issued in FL

Practice address

4300 Alton Rd
Miami Beach, FL 33140-2948

Phone

(305) 481-9776

Fax

(305) 674-2007

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

No

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collins Physician Services, LLCGroup PAC ID 9234476920, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Sinai Medical Center of Florida, Inc Hospital, Miami Beach, FL, CCN 100034

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Collins Physician Services, LLC

  • Hospitalist Physician
  • Miami Beach, FL
  • NPI 1457839524
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Sinai Medical Center of Florida, Inc

  • General Acute Care Hospital
  • Miami Beach, FL
  • NPI 1912964768
  Care Compare affiliation

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1164993432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948",
            "telephone_number": "305-481-9776",
            "fax_number": "305-674-2007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7260 W Troon Cir",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "330146540",
            "country_code": "US",
            "telephone_number": "305-299-5396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDOUSSAUT",
        "first_name": "LAURA",
        "middle_name": "CHARLOTTE VALERI",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9111939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Pawley-Martin, RN
• Jessica Paz, MA CCC SLP
• Carter Peace, RBT
• Pearlens, Inc
• Pediatrix Medical Group of Florida Inc
• Miguel Orlando Pedraja Rodriguez
• Natacha Pedroso Medina, APRN
• Angelika Koebernik Pedroso, D.D.S.
• Liset Pelaez, MD
• Shelsea Pelaez, APRN

• Physician Assistant in Miami Beach, FL
• Providers in Miami 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 Jun 11, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.