Individual provider Active NPI

Tammy A Dorfman, PA-C

  • Surgical Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1225061781
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 9102106 Issued in FL
Practice address
7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone
(954) 265-9430
Fax
(954) 987-2000
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0008246 CO
Surgical Physician Assistant 363AS0400X PA 9102106 FL Primary

Addresses

Primary practice location

7800 Sheridan St
Pembroke Pines, FL 33024-2536

Mailing address

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-9430

Other practice location 1

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-9430

Other practice location 2

2500 Rocky Mountain Ave Ste 350
Loveland, CO 80538-9004
Phone (970) 829-5535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220125002108 NY Practitioner - Physician Assistant 3072594076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026796NYMDPhysical Therapist
PA.0008246COMDPhysician Assistant
PA 9102106FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tammy a Dorfman PA CurrentSince Jan 1, 2014 Accepting new patients
PA Surgical Inc Surgical PastSince Sep 27, 2020 Accepting new patients
Prohealth Select, Inc. Physician Assistant PastSince Dec 17, 2020 Accepting new patients

Locations

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Organizations & group practices 4

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1225061781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-265-9430",
            "fax_number": "954-987-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SHERIDAN ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330242536",
            "telephone_number": "954-265-9430",
            "fax_number": "954-987-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Johnson St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215421",
            "country_code": "US",
            "telephone_number": "954-265-9430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Rocky Mountain Ave Ste 350",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "CO",
            "postal_code": "805389004",
            "country_code": "US",
            "telephone_number": "970-829-5535",
            "fax_number": "970-624-1892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORFMAN",
        "first_name": "TAMMY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008246",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9102106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.