Individual provider Active NPI

Amberle Carlyle, PA

  • Physician Assistant
  • Merritt Island, FL
National Provider Identifier
1316403132
Registry record updated Feb 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9111397 Issued in FL
Practice address
1395 N Courtenay Pkwy Ste 107
Merritt Island, FL 32953-4474
Phone
(321) 453-1955
NPI assigned
Feb 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 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 9111397 FL Primary

Addresses

Primary practice location

1395 N Courtenay Pkwy Ste 107
Merritt Island, FL 32953-4474

Mailing address

1395 N Courtenay Pkwy Ste 107
Merritt Island, FL 32953-4474
Phone (321) 453-1955

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
I20190311000206 FL Practitioner - Physician Assistant 1759620743 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
Telehealth
Offers telehealth services
Group practices
North Point Physicians LLCGroup PAC ID 8820170517, 4 clinicians

Practice addresses (Care Compare)

1395 N Courtenay Pkwy
Suite 107
Merritt Island, FL 32953-4474
Phone (321) 453-1955

Hospital & facility affiliations

  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315
  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9111397FLMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1550361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550361600000",
    "number": "1316403132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 N COURTENAY PKWY STE 107",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534474",
            "telephone_number": "321-453-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 N COURTENAY PKWY STE 107",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534474",
            "telephone_number": "321-453-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLYLE",
        "first_name": "AMBERLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-17",
        "last_updated": "2019-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.