Individual provider Active NPI

Surany Allison Thompson

  • Family Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1497416184
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11017292 Issued in FL
Practice address
20237 Back Nine Dr
Boca Raton, FL 33498-4712
Phone
(561) 797-9377
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11017292 FL Primary

Addresses

Primary practice location

20237 Back Nine Dr
Boca Raton, FL 33498-4712

Mailing address

20237 Back Nine Dr
Boca Raton, FL 33498-4712
Phone (561) 797-9377

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
I20221031000253 FL Practitioner - Nurse Practitioner 1557738887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Boca Raton, FL 33498
Phone (561) 797-9377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11017292FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Care LLC Family CurrentSince Feb 18, 2023 Accepting new patients

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": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1497416184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20237 BACK NINE DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334984712",
            "telephone_number": "561-797-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20237 BACK NINE DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334984712",
            "telephone_number": "561-797-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SURANY",
        "middle_name": "ALLISON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11017292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.