Individual provider Active NPI

Mara O'Mara

  • Physician Assistant
  • Plantation, FL
National Provider Identifier
1265820153
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9108429 Issued in FL
Practice address
8201 W Broward Blvd
Plantation, FL 33324-2701
Phone
(954) 476-3900
NPI assigned
Dec 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 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 9108429 FL Primary

Addresses

Primary practice location

8201 W Broward Blvd
Plantation, FL 33324-2701

Mailing address

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 476-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150428002388 FL Practitioner - Physician Assistant 3779802558 Reassigns benefits to 2 organizations
I20180326002616 CO Practitioner - Physician Assistant 3779802558 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9108429FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Colorado, PC Physician Assistant CurrentSince Mar 14, 2018 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Jun 18, 2016 Accepting new patients
FL-I Medical Services, LLC Physician Assistant CurrentSince Jun 18, 2016 Accepting new patients
Phoenix Emergency Medicine of Broward LLC CurrentSince Jan 1, 2017 Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients
Emergency Professionals of Colorado, PC Physician Assistant Past Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 70th Ave
Greeley, CO 80634
Phone (970) 352-7366

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

3114 Croasdaile Dr
#200
Durham, NC 27705
Phone (877) 751-1157

Organizations & group practices 10

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": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1265820153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242701",
            "telephone_number": "954-476-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242701",
            "telephone_number": "954-476-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MARA",
        "first_name": "MARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-31",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9108429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.