Individual provider Active NPI

Maria M Dutra, PA

  • Medical Physician Assistant
  • Plantation, FL
National Provider Identifier
1194790428
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
8329 W Sunrise Blvd
Plantation, FL 33322-5405
Phone
(546) 271-6179
Fax
(954) 474-3489
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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 Primary

Addresses

Primary practice location

8329 W Sunrise Blvd
Plantation, FL 33322-5405

Mailing address

201 NW 82 Ave
Suite 202
Plantation, FL 33324-1854
Phone (954) 474-3262

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
I20050427000453 FL Practitioner - Physician Assistant 1850330119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.04 of 100Reported as group
Quality
65.4
Promoting interoperability
98
Improvement activities
40
Cost
76.41

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Health, LLC CurrentSince Mar 2, 2020 Accepting new patients

Locations

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

8329 W Sunrise Blvd
Plantation, FL 33322
Phone (954) 627-1617

Organizations & group practices 2

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1194790428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW 82 AVE",
            "address_2": "SUITE 202",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241854",
            "telephone_number": "954-474-3262",
            "fax_number": "954-474-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8329 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225405",
            "telephone_number": "546-271-6179",
            "fax_number": "954-474-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTRA",
        "first_name": "MARIA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.