Individual provider Active NPI

Mariam Azizi, PA-C

  • Physician Assistant
  • Clermont, FL
National Provider Identifier
1487443016
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1950 Hospital View Way
Clermont, FL 34711-1926
Phone
(352) 243-3443
NPI assigned
May 1, 2025
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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 NU Primary

Addresses

Primary practice location

1950 Hospital View Way
Clermont, FL 34711-1926

Mailing address

4570 Capital Dome Dr
Jacksonville, FL 32246-7457

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
I20251112002752 FL Practitioner - Physician Assistant 6002307592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
South Lake Medical Center IncGroup PAC ID 2264521749, 6 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1950 Hospital View Way
Clermont, FL 34711-1926
Phone (352) 243-3443

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Lake Medical Center Inc CurrentSince Sep 5, 2025 Accepting new patients

Locations

1950 Hospital View Way
Clermont, FL 34711
Phone (321) 274-1864

255 Citrus Tower Blvd
Ste 206
Clermont, FL 34711
Phone (352) 242-9600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFJDAA

Organizations & group practices 1

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 3

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": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1487443016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 CAPITAL DOME DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 HOSPITAL VIEW WAY",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111926",
            "telephone_number": "352-243-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIZI",
        "first_name": "MARIAM",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.