Individual provider Active NPI

Stephanie Zelaya

  • Physician Assistant
  • Plantation, FL
National Provider Identifier
1356989305
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9112814 Issued in FL
Practice address
6931 W Broward Blvd
Plantation, FL 33317-2902
Phone
(954) 391-5191
NPI assigned
Dec 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 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 PA9112814 FL Primary

Addresses

Primary practice location

6931 W Broward Blvd
Plantation, FL 33317-2902

Mailing address

15757 Pines Blvd # 164
Pembroke Pines, FL 33027-1207
Phone (305) 984-0506

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
I20210323000184 FL Practitioner - Physician Assistant 9638586407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Medical Center IncGroup PAC ID 2365521788, 10 clinicians

Practice addresses (Care Compare)

6931 W Broward Blvd
Plantation, FL 33317-2902
Phone (954) 321-5191

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro Worx Injury Center Inc CurrentSince Aug 14, 2022 Accepting new patients

Locations

6931 W Broward Blvd
Plantation, FL 33317
Phone (954) 321-5191

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.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1356989305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15757 PINES BLVD # 164",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271207",
            "telephone_number": "305-984-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172902",
            "telephone_number": "954-391-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELAYA",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.