Individual provider Active NPI

Katherine A Wintle, PA-C

  • Physician Assistant
  • Hollywood, FL
National Provider Identifier
1205015674
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9104336 Issued in FL
Practice address
4310 Sheridan St
Hollywood, FL 33021-3554
Phone
(954) 989-3500
Fax
(954) 989-3511
NPI assigned
Nov 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9104336 FL Primary

Addresses

Primary practice location

4310 Sheridan St
Hollywood, FL 33021-3554

Mailing address

4310 Sheridan St
Hollywood, FL 33021-3554
Phone (954) 989-3500

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
I20080107000563 FL Practitioner - Physician Assistant 8820178643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Practitioners, LLCGroup PAC ID 1658688304, 63 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Fort Lauderdale, FL 33334-4149
Phone (954) 229-8635

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 987-2000

3600 Washington St
Hollywood, FL 33021-8216
Phone (954) 966-4500

7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (954) 962-9650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9104336FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Broward Institute of Orthopaedic Specialties LLC CurrentSince Sep 24, 2007 Accepting new patients

Locations

4310 Sheridan St
Hollywood, FL 33021
Phone (954) 963-8177

4400 Sheridan St
Hollywood, FL 33021
Phone (954) 963-3500

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1205015674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213554",
            "telephone_number": "954-989-3500",
            "fax_number": "954-989-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213554",
            "telephone_number": "954-989-3500",
            "fax_number": "954-989-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTLE",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9104336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.