Individual provider Active NPI

Nicolina Ferraresi, PA-C

  • Medical Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1215587647
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9115540 Issued in FL
Practice address
5028 Okeechobee Blvd
West Palm Beach, FL 33417-4534
Phone
(561) 578-6700
NPI assigned
Sep 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9115540 FL Primary
Medical Physician Assistant 363AM0700X MA061053 PA

Addresses

Primary practice location

5028 Okeechobee Blvd
West Palm Beach, FL 33417-4534

Mailing address

129 Hammocks Dr
Greenacres, FL 33413-2055
Phone (410) 980-5932

Other practice location 1

1309 N Flagler Dr
West Palm Beach, FL 33401-3406
Phone (561) 655-5511

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
I20220308003113 FL Practitioner - Physician Assistant 1153715123 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115540FLMDMedical Physician Assistant
MA061053PAMDMedical Physician Assistant

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": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1215587647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 HAMMOCKS DR",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334132055",
            "telephone_number": "410-980-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5028 OKEECHOBEE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174534",
            "telephone_number": "561-578-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1309 N Flagler Dr",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334013406",
            "country_code": "US",
            "telephone_number": "561-655-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRARESI",
        "first_name": "NICOLINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9115540",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061053",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.