Jay D Williams, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9104403 Issued in FL

Practice address

2142 SE 2ND St
Homestead, FL 33033-7213

Phone

(305) 562-6540

NPI assigned

Mar 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Surgical Services PLLCGroup PAC ID 6608959200, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Professional Surgical Services PLLC

  • Surgical Physician Assistant
  • Hialeah, FL
  • NPI 1033302641
  Medicare reassignment Care Compare group
• Orthopedic Innovators Inc

  • Physician Assistant
  • Miami, FL
  • NPI 1548219926
  NPD (past)

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

• South Broward Hospital District

  • General Acute Care Hospital
  • Miramar, FL
  • NPI 1326021197
  Care Compare affiliation

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1467622258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 SE 2ND ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337213",
            "telephone_number": "305-562-6540",
            "fax_number": "305-463-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 SE 2ND ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337213",
            "telephone_number": "305-562-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JAY",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-07",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9104403",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yohann Whitelocke
• Carrie Wilborn
• Alicia Williams
• Dominique Yashanetta Williams, LCSW
• Farrah Williams
• Komonique Williams, CNA, PHLEBOTOMY
• Luisa Odeth Williams
• Marlon Williams
• Nichola Williams
• Norda Williams

• Surgical Physician Assistant in Homestead, FL
• Providers in Homestead, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.