Active NPI
Joanah C Bodero, P.A.
- Surgical Physician Assistant
- Miami Beach, FL
National Provider Identifier
1316100571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA9104352
- Practice address
- 4302 Alton Rd
Suite 830
Miami Beach, FL 33140-2891 - Phone
- (305) 674-2950
- Fax
- (954) 964-6084
- NPI assigned
- Jul 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA9104352 | FL | Primary |
Addresses
Primary practice location
4302 Alton Rd
Suite 830
Miami Beach, FL 33140-2891
Mailing address
PO Box 816759
Hollywood, FL 33081-0759
Phone (954) 964-2450
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080731000323 | FL | Practitioner - Physician Assistant | 1658445218 | Reassigns benefits to 4 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sterling Emergency Services of Miami Beach PA | Current | Accepting new patients |
Locations
2845 NE 199th St
Miami, FL 33180
Phone (305) 692-1000
4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Aventura, FL
- NPI 1083912471
FL
-
- Emergency Medicine Physician
- Miami Beach, FL
- NPI 1659355253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1316100571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 816759",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330810759",
"telephone_number": "954-964-2450",
"fax_number": "954-964-6084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4302 ALTON RD",
"address_2": "SUITE 830",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331402891",
"telephone_number": "305-674-2950",
"fax_number": "954-964-6084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODERO",
"first_name": "JOANAH",
"middle_name": "C",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-08",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA9104352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.