Individual provider Active NPI

Nicole Offenberg, MCMSC, PA

  • Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1407244247
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108441 Issued in FL
Practice address
400 SW 1St Ave
Apt. 407
Fort Lauderdale, FL 33301-3476
Phone
(954) 294-9193
NPI assigned
Jan 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAT9108441 FL
Physician Assistant 363A00000X PA9108441 FL Primary

Addresses

Primary practice location

400 SW 1St Ave
Apt. 407
Fort Lauderdale, FL 33301-3476

Mailing address

400 SW 1St Ave
Apt. 407
Fort Lauderdale, FL 33301-3476
Phone (954) 294-9193

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
I20150512000245 FL Practitioner - Physician Assistant 2365761483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

10081 W Oakland Park Blvd
Unit 1
Sunrise, FL 33351-6919
Phone (954) 579-6858

195 N Federal Hwy
Suite B
Ft Lauderdale, FL 33301-1110
Phone (954) 281-9947

2502 N State Rd
Suite 7
Hollywood, FL 33021-3205
Phone (954) 894-7955

415 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-5528
Phone (954) 457-4333

4570 Lantana Rd
Lake Worth, FL 33463-6908
Phone (561) 963-9881

4640 W Commercial Blvd
Tamarac, FL 33319-3314
Phone (954) 425-9449

5216 N Federal Hwy
Ft. Lauderdale, FL 33308-3202
Phone (954) 958-5858

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9108441FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Jan 15, 2015 Accepting new patients

Locations

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409

Organizations & group practices 1

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": "1420070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1407244247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW 1ST AVE",
            "address_2": "APT. 407",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013476",
            "telephone_number": "954-294-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW 1ST AVE",
            "address_2": "APT. 407",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013476",
            "telephone_number": "954-294-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFENBERG",
        "first_name": "NICOLE",
        "credential": "MCMSC, PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-01",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9108441",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.