Individual provider Active NPI

Fanny Tse, PA-C

  • Physician Assistant
  • Aventura, FL
National Provider Identifier
1457781072
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9107621 Issued in FL
Practice address
21150 Biscayne Blvd Ste 208
Aventura, FL 33180-1231
Phone
(954) 482-4747
NPI assigned
Nov 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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 PA 9107621 FL Primary

Addresses

Primary practice location

21150 Biscayne Blvd Ste 208
Aventura, FL 33180-1231

Mailing address

829 SW 13TH St
Fort Lauderdale, FL 33315-1448
Phone (954) 993-7084

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
I20140303001015 FL Practitioner - Physician Assistant 3971733494 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Cross Hospital Inc 299 clinicians

Practice addresses (Care Compare)

1309 S Federal Hwy
Holy Cross Medical Group
Fort Lauderdale, FL 33316-2040
Phone (954) 463-4383

4725 N Fed Hwy
Ft. Lauderdale, FL 33308-4603
Phone (954) 771-8000

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 542-6000

4725 N Federal Hwy 201
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 565-5807

4725 N Federal Hwy 302
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 351-5931

4725 N Federal Hwy 401
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 772-2136

4725 N Federal Hwy 501
Holy Cross Medical Group
Fort Lauderdale, FL 33308-4603
Phone (954) 351-7770

4725 N Federal Hwy 504
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 414-9750

4725 N Federal Hwy Cancer Ctr
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-7700

4725 N Federal Hwy HCMG Multispecialty
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-6770

4725 N Federal Hwy Neuro Radiology
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5780

4725 N Federal Hwy Nuclear Medicine
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5748

4725 N Federal Hwy Pathology Departmen
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5728

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9107621FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital Inc CurrentSince Dec 10, 2023 Accepting new patients
KND Development 59, LLC CurrentSince Dec 31, 2013 Accepting new patients
Intensive Care Experts Health Network LLC CurrentSince Jan 24, 2015 Accepting new patients
Holy Cross Hospital, Inc CurrentSince Dec 10, 2023 Accepting new patients
KND Development 59, LLC CurrentSince Dec 31, 2013 Accepting new patients

Locations

1516 E Las Olas Blvd
Ft Lauderdale, FL 33301
Phone (954) 356-5142

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

801 Oak St
Green Cv Spgs, FL 32043
Phone (904) 215-7015

701 N Federal Hwy
Ste 601
Hallandale Beach, FL 33009
Phone (954) 573-2195

1859 Van Buren St
Hollywood, FL 33020
Phone (954) 920-0900

21150 Biscayne Blvd
Ste 208
Miami, FL 33180
Phone (305) 534-2155

17180 Royal Palm Blvd
Ste 3
Weston, FL 33326
Phone (787) 462-4662

Interoperability endpoints

  • Direct secure messaging: ftse3227934@direct.trinity-health.org

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1457781072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 SW 13TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333151448",
            "telephone_number": "954-993-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21150 BISCAYNE BLVD STE 208",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801231",
            "telephone_number": "954-482-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSE",
        "first_name": "FANNY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9107621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.