Lisa Ally, PA-C
Individual provider Active NPI Physician Assistant · Pinecrest, FL
NPI 1194929216 · NPPES record last updated Oct 7, 2010
Key facts
- NPI
- 1194929216
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA 9103925 (FL)
- Practice address
- 10205 S Dixie Hwy
102
Pinecrest, FL 33156-3167 - Phone
- (305) 666-0496
- NPI assigned
- Jun 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110329000033 | FL | Practitioner - Physician Assistant | 1254514284 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9103925 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Current Care PA | Current |
Accepting new patients |
Locations
10205 S Dixie Hwy
Ste 102
Pinecrest, FL 33156
Phone (305) 666-0496
5080 Spectrum Dr
Ste 1200W
Addison, TX 75001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9103925 | FL | Yes |
Addresses
Primary practice location
10205 S Dixie Hwy
102
Pinecrest, FL 33156-3167
Mailing address
1031 N 75TH Ave
Hollywood, FL 33024-5351
Phone (305) 298-3116
Other providers in Pinecrest, FL
- Above & Beyond Behavior Development, Inc.
- Julian Daniel Abreu
- Luis Aguirre
- Omar Ali Ahmed Matamoros
- Allbetech Inc
- Alpph Medical Services Corp
- Rosina Esther Altamiranda
- Cari Altman
- Olidaysi Alvarez Diaz
- Mayaly Venegas Alvarez
All providers in Pinecrest, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.