Individual provider Active NPI

Nestor G Via Y Rada, PA-C

  • Surgical Physician Assistant
  • Atlantis, FL
National Provider Identifier
1255409959
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9101346 Issued in FL
Practice address
180 JFK Dr Ste 320
Atlantis, FL 33462-6641
Phone
(561) 548-4900
Fax
(561) 434-5165
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9101346 FL Primary

Addresses

Primary practice location

180 JFK Dr Ste 320
Atlantis, FL 33462-6641

Mailing address

180 JFK Dr Ste 320
Atlantis, FL 33462-6641
Phone (561) 548-4900

Other practice location 1

19538 S Whitewater Ave
Weston, FL 33332-2444
Phone (954) 465-3856

Other identifiers 1

IdentifierTypeStateIssuer
PA9101346OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Select, Inc. Surgical PastSince Dec 17, 2020 Accepting new patients
PA Surgical Inc Surgical PastSince Sep 27, 2020 Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Past Accepting new patients
Vitalmd Group Holding LLC PastSince Jul 7, 2026 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1255409959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 JFK DR STE 320",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626641",
            "telephone_number": "561-548-4900",
            "fax_number": "561-434-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 JFK DR STE 320",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334626641",
            "telephone_number": "561-548-4900",
            "fax_number": "561-434-5165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19538 S Whitewater Ave",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333322444",
            "country_code": "US",
            "telephone_number": "954-465-3856",
            "fax_number": "954-237-7728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIA Y RADA",
        "first_name": "NESTOR",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9101346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9101346",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.