Individual provider Active NPI

Alexa Kishel, PA

  • Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1497390819
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1601 S Andrews Ave FL 2
Fort Lauderdale, FL 33316-2509
Phone
(954) 522-3355
Fax
(954) 522-9590
NPI assigned
Nov 8, 2019
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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 Primary

Addresses

Primary practice location

1601 S Andrews Ave FL 2
Fort Lauderdale, FL 33316-2509

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 522-3355

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
I20200330000071 FL Practitioner - Physician Assistant 3476982323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians
Rehabclinics Pta IncGroup PAC ID 0547237497, shared by 11 NPIs, 209 clinicians

Practice addresses (Care Compare)

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

1601 S Andrews Ave
Fort Lauderdale, FL 33316-2509

1817 E Commercial Blvd
Ft Lauderdale, FL 33308-3767
Phone (954) 836-8980

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospital District CurrentSince Jan 17, 2022 Accepting new patients
North Broward Hospital District CurrentSince Jan 17, 2022 Accepting new patients
North Broward Hospital District Past Accepting new patients
North Broward Hospital District Past Accepting new patients
North Broward Hospital District Past Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

1601 S Andrews Ave
Fl 2
Ft Lauderdale, FL 33316
Phone (954) 355-3490

1608 SE 3rd Ave
Fl 3
Ft Lauderdale, FL 33316

1700 NW 49th St
Ste 125
Ft Lauderdale, FL 33309
Phone (954) 355-3490

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4ec99ef7-2f74-4efb-9ab9-a702c7c570f4/

Organizations & group practices 6

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 1

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": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1497390819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-522-3355",
            "fax_number": "954-522-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S ANDREWS AVE FL 2",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162509",
            "telephone_number": "954-522-3355",
            "fax_number": "954-522-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHEL",
        "first_name": "ALEXA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.