Individual provider Active NPI

Sarah Bergeline Mishmarna Michaud, PHYSICIAN ASSISTANT

  • Family Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1487113684
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
001655-P.A Issued in PR
Practice address
220 SW 38TH Ave Apt 203
Fort Lauderdale, FL 33312-1872
Phone
(954) 692-4120
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
Yes

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 001655-P.A PR Primary
Medical-Surgical Registered Nurse 163WM0705X 885689-01 NY
Surgical Assistant 246ZC0007X 19-153 WI

Addresses

Primary practice location

220 SW 38TH Ave Apt 203
Fort Lauderdale, FL 33312-1872

Mailing address

220 SW 38TH Ave Apt 203
Fort Lauderdale, FL 33312-1872
Phone (954) 692-4120

Other practice location 1

5547 Sandbirch Way
Lake Worth, FL 33463-7203
Phone (954) 692-4120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
885689-01NYMDMedical-Surgical Registered Nurse
001655-P.APRMDFamily Medicine Physician
19-153WIMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1487113684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SW 38TH AVE APT 203",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121872",
            "telephone_number": "954-692-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW 38TH AVE APT 203",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121872",
            "telephone_number": "954-692-4120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5547 Sandbirch Way",
            "address_purpose": "LOCATION",
            "city": "Lake Worth",
            "state": "FL",
            "postal_code": "334637203",
            "country_code": "US",
            "telephone_number": "954-692-4120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAUD",
        "first_name": "SARAH",
        "middle_name": "BERGELINE MISHMARNA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "001655-P.A",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "885689-01",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "19-153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.