Individual provider Active NPI

Denise Andrade, PA

  • Physician Assistant
  • Hollywood, FL
National Provider Identifier
1255437646
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3500 Tyler St
Hollywood, FL 33021-6852
Phone
(954) 987-2047
Fax
(954) 987-2048
NPI assigned
Sep 15, 2006
Last updated
Mar 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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 Primary

Addresses

Primary practice location

3500 Tyler St
Hollywood, FL 33021-6852

Mailing address

2401 Frist Blvd
#7,9, And 10
Fort Pierce, FL 34950-4800
Phone (772) 466-0088

Other identifiers 1

IdentifierTypeStateIssuer
291474300MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080811000192 FL Practitioner - Physician Assistant 1456425370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics and Pain Management, P.L.Group PAC ID 6002985207, 6 clinicians

Practice addresses (Care Compare)

3355 Burns Rd
Palm Beach Gardens, FL 33410-4357
Phone (561) 775-2763

3500 Tyler St
Hollywood, FL 33021-6852
Phone (954) 987-2047

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Andres Vega MD PA PastSince Mar 1, 2002 Accepting new patients
Meridian Pain and Diagnostics Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1255437646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 FRIST BLVD",
            "address_2": "#7,9, AND 10",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504800",
            "telephone_number": "772-466-0088",
            "fax_number": "772-460-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 TYLER ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216852",
            "telephone_number": "954-987-2047",
            "fax_number": "954-987-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "DENISE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291474300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.