Latoyia Dashawn Fuller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9111028 Issued in FL

Practice address

1770 Eagle Trace Blvd
Coral Springs, FL 33071-7817

Phone

(317) 223-1056

NPI assigned

Feb 6, 2018

Last updated

Feb 6, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Latoyia Ball Former name

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland Clinic FloridaGroup PAC ID 7911807128, 717 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital Hospital, Weston, FL, CCN 100289

Merit-based Incentive Payment System (MIPS)

Final score

92.26 of 100Reported as apm

Quality

80.2

Promoting interoperability

99.24

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cleveland Clinic Florida a Nonprofit Corporation

  • Clinic/Center
  • Weston, FL
  • NPI 1215989298
  Medicare reassignment Care Compare group NPD
• Sheridan Radiology Services of Central Florida Inc

  • Diagnostic Radiology Physician
  • Kissimmee, FL
  • NPI 1598923260
  NPD (past)

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

• Cleveland Clinic Weston Hospital Nonprofit Corporation

  dba Cleveland Clinic Hospital

  • General Acute Care Hospital
  • Weston, FL
  • NPI 1083644033
  Care Compare affiliation

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1245739119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 EAGLE TRACE BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330717817",
            "telephone_number": "317-223-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 EAGLE TRACE BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330717817",
            "telephone_number": "317-223-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LATOYIA",
        "middle_name": "DASHAWN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATOYIA",
            "last_name": "BALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Damian Mark Fronzaglia, D.C.
• FS Tenant Pool I Trust (Park Summit)
• Scott Fuchs, M.D.
• Jose Luis Fuentes, LMT
• Deborah K Fuller, PHARM D
• Functional Ways Therapy Services, LLC
• Michael Neal Funk, M.D.
• Morris Funk, M.D.
• Funxion Rehabilitation of Coral Springs
• Kelly Furr

• Physician Assistant in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.