Individual provider Active NPI

Finolia Marie Idahosa, PA

  • Physician Assistant
  • Venice, FL
National Provider Identifier
1245850122
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
492-P.A. Issued in PR
Practice address
312 E Venice Ave Ste 108
Venice, FL 34285-4670
Phone
(917) 385-6081
NPI assigned
Apr 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 492-P.A. PR Primary

Addresses

Primary practice location

312 E Venice Ave Ste 108
Venice, FL 34285-4670

Mailing address

312 E Venice Ave Ste 108
Venice, FL 34285-4670
Phone (917) 385-6081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20231019001916 AZ Practitioner - Physician Assistant 7719399617

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
492-P.A.PRMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Safe & Guard Home Care Inc CurrentSince Aug 2, 2020 Accepting new patients
Azeta Home Care Current Accepting new patients

Locations

312 E Venice Ave
Ste 108
Venice, FL 34285
Phone (917) 385-6081

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17280/brand/1/csg/1/fhir/r4

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": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1245850122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E VENICE AVE STE 108",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342854670",
            "telephone_number": "917-385-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E VENICE AVE STE 108",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342854670",
            "telephone_number": "917-385-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDAHOSA",
        "first_name": "FINOLIA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "492-P.A.",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.