Individual provider Active NPI

Bethany Vigroux, PA

  • Physician Assistant
  • Hollywood, FL
National Provider Identifier
1265711501
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107323 Issued in FL
Practice address
1150 N 35TH Ave
Suite 130
Hollywood, FL 33021-5424
Phone
(954) 265-7700
Fax
(954) 893-3799
NPI assigned
Aug 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7355 MA
Physician Assistant 363A00000X PA9107323 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave
Suite 130
Hollywood, FL 33021-5424

Mailing address

7420 Avenida del Mar Apt 2604
Boca Raton, FL 33433-4875
Phone (508) 813-2342

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
I20140306000189 FL Practitioner - Physician Assistant 1355571613 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Practitioners, LLCGroup PAC ID 1658688304, 63 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Fort Lauderdale, FL 33334-4149
Phone (954) 229-8635

703 N Flamingo Rd
Memorial Hospital West
Pembroke Pines, FL 33028-1006
Phone (954) 436-5000

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9107323FLMDPhysician Assistant
PA7355MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Mar 15, 2017 Accepting new patients
Palm Beach Acute Care Consultants, LLC CurrentSince Mar 9, 2026 Accepting new patients
South Broward Hospital District CurrentSince Mar 15, 2017 Accepting new patients
Asha Wellness LLC PastSince Jul 24, 2022 Accepting new patients
Tamarac Physicians Group Inc PastSince Sep 19, 2005 Accepting new patients

Locations

1150 N 35th Ave
Ste 130
Hollywood, FL 33021
Phone (954) 265-7700

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

227 Professional Way
Wellington, FL 33414
Phone (561) 318-8440

227 Professional Way
Ste 100
Wellington, FL 33414
Phone (561) 318-8440

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1265711501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 AVENIDA DEL MAR APT 2604",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334875",
            "telephone_number": "508-813-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "SUITE 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-7700",
            "fax_number": "954-893-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGROUX",
        "first_name": "BETHANY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7355",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.