Individual provider Active NPI

Graciela Falkon de Cababie, PA

  • Medical Physician Assistant
  • North Miami, FL
National Provider Identifier
1497124390
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109095 Issued in FL
Practice address
11645 Biscayne Blvd Ste 308
North Miami, FL 33181-3139
Phone
(305) 538-8835
Fax
(305) 938-4044
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109095 FL Primary

Addresses

Primary practice location

11645 Biscayne Blvd Ste 308
North Miami, FL 33181-3139

Mailing address

11645 Biscayne Blvd Ste 207
North Miami, FL 33181-3138
Phone (305) 538-8835

Other identifiers 1

IdentifierTypeStateIssuer
015951800MedicaidFL

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
I20151211001436 FL Practitioner - Physician Assistant 5496056673 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Miami Beach Community Health Center Inc CurrentSince Oct 19, 2015 Accepting new patients

Locations

710 Alton Rd
Miami Beach, FL 33139

11645 Biscayne Blvd
Ste 308
North Miami, FL 33181
Phone (305) 895-0010

11645 Biscayne Blvd
Ste 207
North Miami, FL 33181
Phone (704) 297-9229

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.

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1497124390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 207",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813138",
            "telephone_number": "305-538-8835",
            "fax_number": "305-938-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 BISCAYNE BLVD STE 308",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331813139",
            "telephone_number": "305-538-8835",
            "fax_number": "305-938-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALKON DE CABABIE",
        "first_name": "GRACIELA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015951800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.