Active NPI
Gabrielle Eneman-Becker, PA-C
- Physician Assistant
- Plantation, FL
National Provider Identifier
1497030571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9105117
- Practice address
- 9611 W Broward Blvd
Plantation, FL 33324-2334 - Phone
- (954) 924-7000
- NPI assigned
- Oct 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9105117 | FL | |
| Physician Assistant | 363A00000X | PA9105117 | FL | Primary |
Addresses
Primary practice location
9611 W Broward Blvd
Plantation, FL 33324-2334
Mailing address
900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (305) 940-6016
Other practice location 1
4972 Town Center Pkwy
Jacksonville, FL 32246-8595
Phone (904) 642-6100
Other practice location 2
11260 Sullivan St
Riverview, FL 33578-2140
Phone (813) 689-7571
Other practice location 3
1610 NE Miami Gardens Dr
North Miami Beach, FL 33179-4900
Phone (305) 940-6016
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007713400 | Medicaid | FL |
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 |
|---|---|---|---|
| PA9105117 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittel, Levin and Jacobson | Past | Accepting new patients | |
| Saltzman, Tanis, Pittell, Levin and Jacobson | Past | Accepting new patients |
Interoperability endpoints
- geneman-becker@pa.trimed.direct-ci.com
Organizations & group practices 2
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.
-
- Pediatrics Physician
- North Miami Beach, FL
- NPI 1821206525
-
- Pediatrics Physician
- Hollywood, FL
- NPI 1639138480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1497030571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 S PINE ISLAND RD",
"address_2": "SUITE 800",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333243920",
"telephone_number": "305-940-6016",
"fax_number": "305-940-6167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9611 W BROWARD BLVD",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333242334",
"telephone_number": "954-924-7000"
}
],
"practiceLocations": [
{
"address_1": "4972 Town Center Pkwy",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322468595",
"country_code": "US",
"telephone_number": "904-642-6100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11260 Sullivan St",
"address_purpose": "LOCATION",
"city": "Riverview",
"state": "FL",
"postal_code": "335782140",
"country_code": "US",
"telephone_number": "813-689-7571",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1610 NE Miami Gardens Dr",
"address_purpose": "LOCATION",
"city": "North Miami Beach",
"state": "FL",
"postal_code": "331794900",
"country_code": "US",
"telephone_number": "305-940-6016",
"fax_number": "305-940-6167",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ENEMAN-BECKER",
"first_name": "GABRIELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-20",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9105117",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9105117",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007713400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plantation, FL
- Empowered Flower
- Empowered Flower Inc
- Empowerment Counseling Group, Inc
- Empowerment Solutions Therapy, LLC
- Terri Elaine Encalada
- Karen Elaine Engebretsen, PSYD
- Enlightened Mind Counseling LLC
- Bernardino Orestes Enriquez, GENERAL RADIOGRAPHER
- Entyre Care Florida, LLC
- Envision Counseling Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.