Individual provider Active NPI

William Daniel Correal, PA-C

  • Medical Physician Assistant
  • Coral Springs, FL
National Provider Identifier
1407120272
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109760 Issued in FL
Practice address
5810 Coral Ridge Dr Ste 300
Coral Springs, FL 33076-3377
Phone
(954) 414-7700
Fax
(954) 840-0850
NPI assigned
Feb 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109760 FL Primary

Addresses

Primary practice location

5810 Coral Ridge Dr Ste 300
Coral Springs, FL 33076-3377

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (954) 753-7870

Other identifiers 1

IdentifierTypeStateIssuer
107282500MedicaidFL

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)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109760FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson Past Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC PastSince Jul 17, 2022 Accepting new patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Past Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Past Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Past Accepting new patients
M.Haroon Siddiqui M.D.,P.a. PastSince Mar 9, 2020 Accepting new patients

Organizations & group practices 6

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": "1330214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1407120272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "954-753-7870",
            "fax_number": "954-752-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 CORAL RIDGE DR STE 300",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763377",
            "telephone_number": "954-414-7700",
            "fax_number": "954-840-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREAL",
        "first_name": "WILLIAM",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-26",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107282500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.