Individual provider Active NPI

Maria Del Pilar Roa, MSN, APRN, FNP-C, RN

  • Family Nurse Practitioner
  • Lake Worth, FL
National Provider Identifier
1407407695
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11004606 Issued in FL
Practice address
330 S Dixie Hwy
Lake Worth, FL 33460-4400
Phone
(561) 227-3993
Fax
(561) 855-4308
NPI assigned
Sep 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9496864 FL
Family Nurse Practitioner 363LF0000X 11004606 FL Primary

Addresses

Primary practice location

330 S Dixie Hwy
Lake Worth, FL 33460-4400

Mailing address

4585 San Fratello Cir
Lake Worth, FL 33467-5074
Phone (561) 227-3993

Other practice location 1

3255 Forest Hill Blvd
Palm Springs, FL 33406-5854
Phone (561) 964-4577

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
I20200416003981 FL Practitioner - Nurse Practitioner 3971933805

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3255 Forest Hill
Suite 103
West Palm Beach, FL 33406-5854

3255 Forest Hill Blvd
Palm Springs, FL 33406-5854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
9496864FLMDRegistered Nurse
11004606FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Medical Center, PA CurrentSince Mar 3, 2020 Accepting new patients
Soma Medical Center, PA CurrentSince Mar 3, 2020 Accepting new patients
Soma Medical Center PA #5 CurrentSince Mar 27, 2023 Accepting new patients
Soma Medical Center, P. a #4 Past Accepting new patients

Locations

330 N Dixie Hwy
Lake Worth, FL 33460

330 S Dixie Hwy
Ste 3
Lake Worth, FL 33460
Phone (561) 275-1155

330 S Dixie Hwy
Lake Worth Beach, FL 33460
Phone (561) 227-3993

3255 Forest Hill Blvd
#103
West Palm Beach, FL 33406
Phone (561) 964-4577

3255 Forest Hill Blvd
West Palm Beach, FL 33406
Phone (561) 433-5050

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AWCHU1
  • FHIR API: https://fhir4.healow.com/fhir/r4/EFIECD
  • FHIR API: https://fhir4.healow.com/fhir/r4/IFGECD

Organizations & group practices 4

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": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1407407695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 SAN FRATELLO CIR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334675074",
            "telephone_number": "561-227-3993",
            "fax_number": "561-855-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S DIXIE HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334604400",
            "telephone_number": "561-227-3993",
            "fax_number": "561-855-4308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3255 Forest Hill Blvd",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "FL",
            "postal_code": "334065854",
            "country_code": "US",
            "telephone_number": "561-964-4577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROA",
        "first_name": "MARIA",
        "middle_name": "DEL PILAR",
        "credential": "MSN, APRN, FNP-C, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9496864",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.