Didier Mbenza, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9106549 Issued in FL

Practice address

3500 N State Road 7
Suite 211
Lauderdale Lakes, FL 33319-5600

Phone

(954) 766-4233

Fax

(954) 306-2056

NPI assigned

Aug 9, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Pinecrest, FL
  • NPI 1770719296
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1245587161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N STATE ROAD 7",
            "address_2": "SUITE 211",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195600",
            "telephone_number": "954-766-4233",
            "fax_number": "954-306-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N STATE ROAD 7",
            "address_2": "SUITE 211",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195600",
            "telephone_number": "954-766-4233",
            "fax_number": "954-306-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBENZA",
        "first_name": "DIDIER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "PA9106549",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew L Carr MD PA
• Matthew L. Carr, M.D.
• Maximum Home Health, Inc
• Tamika M Maxwell, DO
• Crystal Mayo, MSW
• Sandra-Dee Marie Estella McCook
• Turron Dakie McCoy
• Sabrina Lynette McDougal
• McFadden Express
• Whitney N McFadden

• Medical Physician Assistant in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.