Individual provider Active NPI

Priscila Marie Gamiotea

  • Surgical Physician Assistant
  • Plantation, FL
National Provider Identifier
1205327749
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9111255 Issued in FL
Practice address
499 NW 70TH Ave Ste 200
Plantation, FL 33317-7578
Phone
(954) 223-5483
Fax
(954) 223-5484
NPI assigned
May 21, 2018
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9111255 FL Primary

Addresses

Primary practice location

499 NW 70TH Ave Ste 200
Plantation, FL 33317-7578

Mailing address

499 NW 70TH Ave Ste 200
Plantation, FL 33317-7578
Phone (954) 223-5483

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
I20180713000130 FL Practitioner - Physician Assistant 0143576686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elite Spine and Wellness, LLCGroup PAC ID 1456738822, 4 clinicians

Practice addresses (Care Compare)

499 NW 70TH Ave
Suite 200
Plantation, FL 33317-7578
Phone (954) 223-5483

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9111255FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services II, LLC Surgical CurrentSince Jan 1, 2019 Accepting new patients

Locations

3000 Bayview Dr
Ft Lauderdale, FL 33306
Phone (954) 393-1708

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

Interoperability endpoints

  • Direct secure messaging: pgamiotea2022560@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1205327749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 NW 70TH AVE STE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333177578",
            "telephone_number": "954-223-5483",
            "fax_number": "954-223-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 NW 70TH AVE STE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333177578",
            "telephone_number": "954-223-5483",
            "fax_number": "954-223-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMIOTEA",
        "first_name": "PRISCILA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9111255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.