Organization Active NPI

Mobile Medics Ancillary Services Inc

  • Family Nurse Practitioner
  • Parkland, FL
National Provider Identifier
1417187261
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9165576 Issued in FL
Legal business name
MOBILE MEDICS ANCILLARY SERVICES INC
Practice address
8910 W Parkland Bay TRL
Parkland, FL 33076-4872
Phone
(954) 562-5855
Fax
(954) 775-0019
NPI assigned
Jul 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Mukesh Wadhwa, NPNPI 1306843982
Title
Office Director
Phone
(954) 562-5855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 14086 FL
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 9165576 FL Primary

Addresses

Primary practice location

8910 W Parkland Bay TRL
Parkland, FL 33076-4872

Mailing address

8910 W Parkland Bay TRL
Parkland, FL 33076-4872
Phone (954) 562-5855

Other practice location 1

9513 Kenley Ct
Parkland, FL 33076-4406
Phone (954) 562-5855

Other identifiers 3

IdentifierTypeStateIssuer
111782700MedicaidFL
Y03VKOtherFLBCBS
9239596OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091019000150 FL Part B Supplier - Clinic/Group Practice 1153468533 Receives reassigned benefits from 3 practitioners

National Provider Directory

National Provider Directory

Locations

1209 NW 8TH St
Boca Raton, FL 33486
Phone (561) 465-5345

1050 SW 24th Ave
Deerfield Beach, FL 33442
Phone (954) 360-7667

1454 NE 56th St
Ft Lauderdale, FL 33334
Phone (754) 235-5335

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1417187261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8910 W PARKLAND BAY TRL",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330764872",
            "telephone_number": "954-562-5855",
            "fax_number": "954-775-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 W PARKLAND BAY TRL",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330764872",
            "telephone_number": "954-562-5855",
            "fax_number": "954-775-0019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9513 Kenley Ct",
            "address_purpose": "LOCATION",
            "city": "Parkland",
            "state": "FL",
            "postal_code": "330764406",
            "country_code": "US",
            "telephone_number": "954-562-5855",
            "fax_number": "954-753-1967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOBILE MEDICS ANCILLARY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "WADHWA",
        "authorized_official_first_name": "MUKESH",
        "authorized_official_title_or_position": "OFFICE DIRECTOR",
        "authorized_official_telephone_number": "954-562-5855",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "14086",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9165576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111782700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y03VK",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9239596",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.