Individual provider Active NPI

Ondene Forrest, PA-C

  • Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1356527139
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9104432 Issued in FL
Practice address
603 N Flamingo Rd
Suite 350
Pembroke Pines, FL 33028-1023
Phone
(954) 435-5100
Fax
(954) 435-5816
NPI assigned
Jan 11, 2008
Last updated
Sep 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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 PA 9104432 FL Primary

Addresses

Primary practice location

603 N Flamingo Rd
Suite 350
Pembroke Pines, FL 33028-1023

Mailing address

603 N Flamingo Rd
Suite 350
Pembroke Pines, FL 33028-1023
Phone (954) 435-5100

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
I20080812000228 FL Practitioner - Physician Assistant 4082789987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Care Physicians LLCGroup PAC ID 0840364790, 9 clinicians

Practice addresses (Care Compare)

7740 Boynton Beach Blvd
Boynton Beach, FL 33437-3804
Phone (561) 752-5592

9325 Glades Rd
Suite 207
Boca Raton, FL 33434-3988
Phone (561) 487-7575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.94 of 100Reported as group
Quality
100
Improvement activities
40
Cost
59.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9104432FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince May 8, 2017 Accepting new patients

Locations

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

603 N Flamingo Rd
Ste 350
Pembroke Pnes, FL 33028
Phone (954) 435-5100

Interoperability endpoints

  • Direct secure messaging: forresto@riverchasedermatology.emadirect.md

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.

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": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1356527139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD",
            "address_2": "SUITE 350",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281023",
            "telephone_number": "954-435-5100",
            "fax_number": "954-435-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD",
            "address_2": "SUITE 350",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281023",
            "telephone_number": "954-435-5100",
            "fax_number": "954-435-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORREST",
        "first_name": "ONDENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9104432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.