Individual provider Active NPI

Diana Avakyan, PA-C MS

  • Medical Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1386181667
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9115755 Issued in FL
Practice address
8177 Glades Road
Bay25
Boca Raton, FL 33434-3285
Phone
(561) 955-0525
NPI assigned
Jan 25, 2017
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 020543 NY
Medical Physician Assistant 363AM0700X PA9115755 FL Primary

Addresses

Primary practice location

8177 Glades Road
Bay25
Boca Raton, FL 33434-3285

Mailing address

8177 Glades Road
Bay25
Boca Raton, FL 33434-3285
Phone (561) 955-0525

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
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9115755FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kleydman Dermatology, PLLC PastSince Oct 31, 2013 Accepting new patients
Howard D. Solomon, DO, PC Past Accepting new patients
Alexander Rabinovich Medical PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1386181667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8177 GLADES ROAD",
            "address_2": "BAY25",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343285",
            "telephone_number": "561-955-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8177 GLADES ROAD",
            "address_2": "BAY25",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343285",
            "telephone_number": "561-955-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVAKYAN",
        "first_name": "DIANA",
        "name_prefix": "Mrs.",
        "credential": "PA-C MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "020543",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9115755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.