Individual provider Active NPI

Celia Reznitsky, PA-C

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1295379444
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9112523 Issued in FL
Practice address
2630 NE 203Rd St Ste 105
Miami, FL 33180-1903
Phone
(305) 692-8998
NPI assigned
Oct 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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 9112523 FL Primary

Addresses

Primary practice location

2630 NE 203Rd St Ste 105
Miami, FL 33180-1903

Mailing address

1101 NE 170TH St
Miami, FL 33162-2633
Phone (305) 989-9367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20201116001582 MD Practitioner - Physician Assistant 3870904295 Reassigns benefits to 1 organization
I20210107000084 DC Practitioner - Physician Assistant 3870904295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On Site Dermatology Associates LLCGroup PAC ID 6406039973, 5 clinicians

Practice addresses (Care Compare)

11630 Glen Arm Rd
Glen Arm, MD 21057-9403
Phone (877) 345-5300

13801 York Rd
Cockeysville, MD 21030-1825
Phone (877) 345-5300

300 International Cir
Cockeysville, MD 21030-1300
Phone (877) 345-5300

300 Saint Luke Cir
Westminster, MD 21158-4174
Phone (877) 345-5300

3050 Military Rd NW
Washington, DC 20015-1341
Phone (877) 345-5300

3110 Gracefield Rd
Silver Spring, MD 20904-1820
Phone (877) 345-5300

3160 Gracefield Rd
Silver Spring, MD 20904-1986
Phone (877) 345-5300

3200 Baker Cir
Adamstown, MD 21710-9653
Phone (877) 345-5300

615 Chestnut Ave
Towson, MD 21204-3742
Phone (877) 345-5300

701 King Farm Blvd
Rockville, MD 20850-6165
Phone (877) 345-5300

709 Maiden Choice LN
Catonsville, MD 21228-3934
Phone (877) 345-5300

711 Maiden Choice LN
Catonsville, MD 21228-3632
Phone (877) 345-5300

721 Maiden Choice LN
Catonsville, MD 21228-6205
Phone (877) 345-5300

800 Bestgate Rd
Annapolis, MD 21401-3016
Phone (877) 345-5300

8507 Mapleville Rd
Boonsboro, MD 21713-1818
Phone (877) 345-5300

8800 Walther Blvd
Oak Crest Senior Living
Parkville, MD 21234-9001
Phone (877) 345-5300

8832 Walther Blvd
Renaissance Gardens at Oak Crest
Parkville, MD 21234-9020
Phone (877) 345-5300

9657 Belair Rd
Nottingham, MD 21236-1124
Phone (877) 345-5300

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9112523FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Resnik Dermatology Aventura, PA CurrentSince Nov 3, 2019 Accepting new patients

Locations

2630 NE 203rd St
Ste 105
Miami, FL 33180
Phone (305) 692-8998

Organizations & group practices 2

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": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1295379444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 NE 170TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331622633",
            "telephone_number": "305-989-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 NE 203RD ST STE 105",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331801903",
            "telephone_number": "305-692-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNITSKY",
        "first_name": "CELIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.