Individual provider Active NPI

Alana Beth Willis, PA-C

  • Physician Assistant
  • Plantation, FL
National Provider Identifier
1447838503
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117183 Issued in FL
Practice address
333 NW 70TH Ave Ste 116
Plantation, FL 33317-2364
Phone
(954) 371-2208
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9117183 FL Primary

Addresses

Primary practice location

333 NW 70TH Ave Ste 116
Plantation, FL 33317-2364

Mailing address

333 NW 70TH Ave Ste 116
Plantation, FL 33317-2364
Phone (954) 371-2208

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
I20240319003125 FL Practitioner - Physician Assistant 3173900115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern Univ College of Dental Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Derm Group LLPGroup PAC ID 9335478908, 32 clinicians

Practice addresses (Care Compare)

11760 Bird Rd
Suite 451
Miami, FL 33175-3598
Phone (305) 245-1332

333 NW 70TH Ave
Suite 116
Plantation, FL 33317-2364
Phone (954) 371-2208

National Provider Directory

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

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1447838503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NW 70TH AVE STE 116",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172364",
            "telephone_number": "954-371-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NW 70TH AVE STE 116",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172364",
            "telephone_number": "954-371-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ALANA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.