Individual provider Active NPI

Marie-Claude Dubuc, PA-C

  • Primary Care Nurse Practitioner
  • Coconut Creek, FL
National Provider Identifier
1174849160
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
PA9105167 Issued in FL
Practice address
5300 W Hillsboro Blvd
Suite a-101
Coconut Creek, FL 33073-4395
Phone
(954) 571-7727
NPI assigned
Apr 15, 2010
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X PA9105167 FL Primary

Addresses

Primary practice location

5300 W Hillsboro Blvd
Suite a-101
Coconut Creek, FL 33073-4395

Mailing address

5300 W Hillsboro Blvd
Suite a-101
Coconut Creek, FL 33073-4395

Other identifiers 1

IdentifierTypeStateIssuer
260446935OtherTAX ID

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
I20120319000810 FL Practitioner - Physician Assistant 8022278647 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9105167FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services, LLC CurrentSince Nov 17, 2019 Accepting new patients
Tenet-Solantic Joint Venture LLC PastSince Nov 22, 2010 Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1174849160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W HILLSBORO BLVD",
            "address_2": "SUITE A-101",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W HILLSBORO BLVD",
            "address_2": "SUITE A-101",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734395",
            "telephone_number": "954-571-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBUC",
        "first_name": "MARIE-CLAUDE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "PA9105167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "260446935",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.