Individual provider Active NPI

Ximena Guimet, PA

  • Medical Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1457619207
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9106462 Issued in FL
Practice address
603 N Flamingo Rd
357
Pembroke Pines, FL 33028-1023
Phone
(954) 450-8488
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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 9106462 FL Primary

Addresses

Primary practice location

603 N Flamingo Rd
357
Pembroke Pines, FL 33028-1023

Mailing address

2300 N Sherman Cir
107
Miramar, FL 33025-5161
Phone (954) 654-5633

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
I20130626000724 FL Practitioner - Physician Assistant 2264671098 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9106462FLMDMedical Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1457619207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N SHERMAN CIR",
            "address_2": "107",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330255161",
            "telephone_number": "954-654-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD",
            "address_2": "357",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281023",
            "telephone_number": "954-450-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIMET",
        "first_name": "XIMENA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9106462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.