Individual provider Active NPI

Tatsiana Yarashevich

  • Medical Physician Assistant
  • Hallandale Beach, FL
National Provider Identifier
1295219541
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9111592 Issued in FL
Practice address
2500 E Hallandale Beach Blvd Ste 301
Hallandale Beach, FL 33009-4835
Phone
(954) 458-2572
NPI assigned
Sep 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9111592 FL Primary

Addresses

Primary practice location

2500 E Hallandale Beach Blvd Ste 301
Hallandale Beach, FL 33009-4835

Mailing address

2500 E Hallandale Beach Blvd Ste 301
Hallandale Beach, FL 33009-4835
Phone (954) 458-2572

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
I20190415000884 FL Practitioner - Physician Assistant 7012258379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Local Specialty Care IncGroup PAC ID 3971591231, 29 clinicians

Practice addresses (Care Compare)

2500 E Hallandale Beach Blvd
Suite 301
Hallandale Beach, FL 33009-4835
Phone (954) 458-2572

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9111592FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Local Specialty Care, Inc Past Accepting new patients
Complete Local Specialty Care, Inc. PastSince Jun 6, 2021 Accepting new patients
Mel-Bay Health Care Inc PastSince Jul 17, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJGBDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEGBA

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": "1537574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1295219541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E HALLANDALE BEACH BLVD STE 301",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094835",
            "telephone_number": "954-458-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E HALLANDALE BEACH BLVD STE 301",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094835",
            "telephone_number": "954-458-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARASHEVICH",
        "first_name": "TATSIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-22",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9111592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

Verify at the official NPI Registry.