Active NPI
Sarah Bergeline Mishmarna Michaud, PHYSICIAN ASSISTANT
- Family Medicine Physician
- Fort Lauderdale, FL
National Provider Identifier
1487113684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 001655-P.A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 885689-01 | NY | MD | Medical-Surgical Registered Nurse |
| 001655-P.A | PR | MD | Family Medicine Physician |
| 19-153 | WI | MD | Surgical 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.