Individual provider Active NPI

Osvany Bermudez, MMS, PA-C

  • Medical Physician Assistant
  • Tamarac, FL
National Provider Identifier
1194231522
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9110952 Issued in FL
Practice address
7421 N University Dr Ste 206
Tamarac, FL 33321-2953
Phone
(954) 724-7410
Fax
(954) 724-7412
NPI assigned
Dec 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9110952 FL Primary

Addresses

Primary practice location

7421 N University Dr Ste 206
Tamarac, FL 33321-2953

Mailing address

7421 N University Dr Ste 206
Tamarac, FL 33321-2953
Phone (954) 724-7410

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
I20180301000347 FL Practitioner - Physician Assistant 4789945056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osvaldo a Torres MD LLCGroup PAC ID 1557512902, 5 clinicians

Practice addresses (Care Compare)

7421 N University Dr
Sutie 206
Tamarac, FL 33321-2953
Phone (954) 724-7410

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDCBCD/Endpoint/DDCBCD

Organizations & group practices 1

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1194231522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 N UNIVERSITY DR STE 206",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212953",
            "telephone_number": "954-724-7410",
            "fax_number": "954-724-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7421 N UNIVERSITY DR STE 206",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212953",
            "telephone_number": "954-724-7410",
            "fax_number": "954-724-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "OSVANY",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.