Individual provider Active NPI

Edlira Maska, M.D.

  • Internal Medicine Physician
  • Wellington, FL
National Provider Identifier
1477845428
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME119335 Issued in FL
Practice address
10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone
(561) 472-2590
Fax
(561) 227-0161
NPI assigned
May 10, 2011
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN16048 FL
Internal Medicine Physician 207R00000X ME119335 FL Primary

Addresses

Primary practice location

10101 Forest Hill Blvd
Wellington, FL 33414-6103

Mailing address

10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone (561) 472-2583

Other identifiers 1

IdentifierTypeStateIssuer
011710200MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140624002151 FL Practitioner - Internal Medicine 9830330612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellington Physician Alliances IncGroup PAC ID 4587720743, 3 clinicians

Practice addresses (Care Compare)

10111 Forest Hill Blvd
RM 231
Wellington, FL 33414-6157
Phone (561) 472-2590

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN16048FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Internal Medicine Current Accepting new patients
Wellington Physician Alliances Inc Internal Medicine CurrentSince Feb 28, 2022 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2014 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2014 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

10111 Forest Hill Blvd
Rm 231
West Palm Beach, FL 33414
Phone (561) 472-2590

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1477845428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146103",
            "telephone_number": "561-472-2583",
            "fax_number": "561-472-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146103",
            "telephone_number": "561-472-2590",
            "fax_number": "561-227-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASKA",
        "first_name": "EDLIRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN16048",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME119335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011710200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.