Active NPI
Mary Elisa Strennen, PA-C
- Surgical Physician Assistant
- Fort Lauderdale, FL
National Provider Identifier
1316271794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA9105214
- Practice address
- 6550 N Federal Hwy
Suite 512
Fort Lauderdale, FL 33308-1404 - Phone
- (954) 267-9777
- Fax
- (954) 772-7801
- NPI assigned
- Oct 1, 2009
- Last updated
- Oct 1, 2009
- Sex
- Female
- Sole proprietor
- No
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 | PA9105214 | FL | Primary |
Addresses
Primary practice location
6550 N Federal Hwy
Suite 512
Fort Lauderdale, FL 33308-1404
Mailing address
6550 N Federal Hwy
Suite 512
Fort Lauderdale, FL 33308-1404
Phone (954) 267-9777
Other names 1
- Mary Elisa Memon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Select, Inc. | Surgical | Past | Accepting new patients |
| David H Gilbert MD and Associates PA | Past | Accepting new patients | |
| PA Surgical Inc | Surgical | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254355200000",
"number": "1316271794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6550 N FEDERAL HWY",
"address_2": "SUITE 512",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333081404",
"telephone_number": "954-267-9777",
"fax_number": "954-772-7801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6550 N FEDERAL HWY",
"address_2": "SUITE 512",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333081404",
"telephone_number": "954-267-9777",
"fax_number": "954-772-7801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRENNEN",
"first_name": "MARY",
"middle_name": "ELISA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-01",
"last_updated": "2009-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA9105214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "MEMON",
"middle_name": "ELISA",
"credential": "CST",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.