Individual provider Active NPI

Mayret Padron, PA-C

  • Medical Physician Assistant
  • Miami, FL
National Provider Identifier
1447578091
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105353 Issued in FL
Practice address
3659 S Miami Ave
Suite#5004
Miami, FL 33133-4227
Phone
(305) 854-0616
Fax
(305) 854-4384
NPI assigned
May 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2010

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 PA9105353 FL Primary

Addresses

Primary practice location

3659 S Miami Ave
Suite#5004
Miami, FL 33133-4227

Mailing address

3659 S Miami Ave
Suite#5004
Miami, FL 33133-4227
Phone (305) 854-0616

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
I20241119003221 FL Practitioner - Physician Assistant 7517267206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Casablanca Medical LLCGroup PAC ID 7911346812, 2 clinicians

Practice addresses (Care Compare)

840 E 25TH St
Hialeah, FL 33013-3402
Phone (305) 890-6800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105353FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Physicians of South Florida LLC Past Accepting new patients

Organizations & group practices 2

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": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1447578091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE",
            "address_2": "SUITE#5004",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334227",
            "telephone_number": "305-854-0616",
            "fax_number": "305-854-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE",
            "address_2": "SUITE#5004",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334227",
            "telephone_number": "305-854-0616",
            "fax_number": "305-854-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRON",
        "first_name": "MAYRET",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-06",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.