Individual provider Active NPI

Kindal Alysse Sweet, PA-C

  • Physician Assistant
  • Boynton Beach, FL
National Provider Identifier
1174956031
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110564 Issued in FL
Practice address
10301 Hagen Ranch Rd Ste D720
Boynton Beach, FL 33437-3777
Phone
(561) 402-3971
NPI assigned
Aug 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9110564 FL
Physician Assistant 363A00000X PA9110564 FL Primary
Medical Physician Assistant 363AM0700X AZ

Addresses

Primary practice location

10301 Hagen Ranch Rd Ste D720
Boynton Beach, FL 33437-3777

Mailing address

PO Box 2400
Melbourne, FL 32902-2400
Phone (321) 255-9671

Other practice location 1

7677 W Paradise Ln Apt 1128
Peoria, AZ 85382-4974
Phone (407) 474-9351

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
I20171122001964 FL Practitioner - Physician Assistant 3375770696 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Stedfast Medical Services LLCGroup PAC ID 4981000999, 46 clinicians

Practice addresses (Care Compare)

3365 Burns Rd
Suite 203
Palm Beach Gardens, FL 33410-4303
Phone (561) 402-3971

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5414AZMDDentist
PA9110564FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Medical Centers LLC Past Accepting new patients
Bobcat Emergency Physicians LLC Physician Assistant Past Accepting new patients

Organizations & group practices 5

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": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1174956031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2400",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329022400",
            "telephone_number": "321-255-9671",
            "fax_number": "603-893-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH RD STE D720",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373777",
            "telephone_number": "561-402-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7677 W Paradise Ln Apt 1128",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853824974",
            "country_code": "US",
            "telephone_number": "407-474-9351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWEET",
        "first_name": "KINDAL",
        "middle_name": "ALYSSE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110564",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110564",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.