Individual provider Active NPI

Craig Michael Cappola

  • Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1316616618
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114866 Issued in FL
Practice address
950 Glades Rd Ste 4a
Boca Raton, FL 33431-6401
Phone
(561) 391-8086
NPI assigned
Sep 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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 PA9114866 FL Primary

Addresses

Primary practice location

950 Glades Rd Ste 4a
Boca Raton, FL 33431-6401

Mailing address

4855 W Hillsboro Blvd Ste B2
Coconut Creek, FL 33073-4356
Phone (954) 418-1683

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
I20211005003604 FL Practitioner - Physician Assistant 2365840378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

950 Glades Rd
Boca Raton, FL 33431-6401
Phone (561) 391-8086

Hospital & facility affiliations

  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Local Specialty Care, Inc. CurrentSince Sep 12, 2021 Accepting new patients

Locations

950 Glades Rd
Ste 4A
Boca Raton, FL 33431
Phone (561) 391-8086

4855 W Hillsboro Blvd
Ste B2
Coconut Creek, FL 33073
Phone (954) 418-1683

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.

Hospital & facility affiliations 1

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": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1316616618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W HILLSBORO BLVD STE B2",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734356",
            "telephone_number": "954-418-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 GLADES RD STE 4A",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316401",
            "telephone_number": "561-391-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPOLA",
        "first_name": "CRAIG",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.