Individual provider Active NPI

Hanna Elisabeth Hemmati, PA

  • Physician Assistant
  • Plantation, FL
National Provider Identifier
1558022426
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117819 Issued in FL
Practice address
220 SW 84TH Ave Ste 102
Plantation, FL 33324-2729
Phone
(954) 720-1530
Fax
(954) 720-6540
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9117819 FL
Surgical Physician Assistant 363AS0400X PA9117819 FL
Physician Assistant 363A00000X PA9117819 FL Primary

Addresses

Primary practice location

220 SW 84TH Ave Ste 102
Plantation, FL 33324-2729

Mailing address

220 SW 84TH Ave Ste 102
Plantation, FL 33324-2729
Phone (954) 349-2345

Other practice location 1

1600 Town Center Blvd Ste C
Weston, FL 33326-3641
Phone (954) 389-5900

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
I20240215004540 FL Practitioner - Physician Assistant 4082058144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Medicine Associates of South Florida PAGroup PAC ID 2264418490, 7 clinicians

Practice addresses (Care Compare)

1600 Town Ctr Blvd
Suite C
Weston, FL 33326-3641
Phone (954) 389-5751

Hospital & facility affiliations

  • Westside Regional Medical Center Hospital, Plantation, FL, CCN 100228

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Ankle & Leg Specialists of South Florida Inc PastSince Apr 15, 2021 Accepting new patients

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.

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": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1558022426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE STE 102",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242729",
            "telephone_number": "954-349-2345",
            "fax_number": "954-349-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE STE 102",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242729",
            "telephone_number": "954-720-1530",
            "fax_number": "954-720-6540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Town Center Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333263641",
            "country_code": "US",
            "telephone_number": "954-389-5900",
            "fax_number": "954-389-5751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEMMATI",
        "first_name": "HANNA",
        "middle_name": "ELISABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9117819",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9117819",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.