Individual provider Active NPI

Karilin Campos Williams, PA-C

  • Physician Assistant
  • Boynton Beach, FL
National Provider Identifier
1497396469
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9112648 Issued in FL
Practice address
1800 W Woolbright Rd Ste 201
Boynton Beach, FL 33426-6398
Phone
(561) 737-8584
NPI assigned
Oct 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 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 PA9112648 FL Primary

Addresses

Primary practice location

1800 W Woolbright Rd Ste 201
Boynton Beach, FL 33426-6398

Mailing address

6421 Congress Ave Ste 113
Boca Raton, FL 33487-2858
Phone (561) 939-0193

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
I20200820000950 FL Practitioner - Physician Assistant 7012333024 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9112648FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: kacampos@entaaf.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1497396469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 CONGRESS AVE STE 113",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872858",
            "telephone_number": "561-939-0193",
            "fax_number": "561-338-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W WOOLBRIGHT RD STE 201",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266398",
            "telephone_number": "561-737-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KARILIN",
        "middle_name": "CAMPOS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.