Mona Entezari, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105261 Issued in FL

Practice address

4800 N. Federal Hwy
Suite C100
Boca Raton, FL 33431

Phone

(800) 407-4319

Fax

(561) 886-0981

NPI assigned

Jul 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Sanctuary Medical Aesthetic Center of Boca Raton LLC

  • Dermatology Physician
  • Boca Raton, FL
  • NPI 1104282714
  NPD

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1295047801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SW 101ST TERRACE",
            "address_2": "UNIT #411",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33025",
            "telephone_number": "954-319-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N. FEDERAL HWY",
            "address_2": "SUITE C100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33431",
            "telephone_number": "800-407-4319",
            "fax_number": "561-886-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTEZARI",
        "first_name": "MONA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Lenore Ensink, LCSW
• Enspire Beauty and Wellness, PLLC
• ENT and Allergy Associates of Florida, LLC
• ENT and Allergy Associates of Florida, LLC
• ENT Hearing Associates of South Florida, Inc
• Esther Urman Entin, LCSW
• Envision Total Care, LLC
• Awele Enwemnwa
• Epoche Medical LLC
• Allie Epstein

• Physician Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.