Individual provider Active NPI

Eden Avni, PA-C

  • Physician Assistant
  • Plantation, FL
National Provider Identifier
1578076410
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110714 Issued in FL
Practice address
950 S Pine Island Rd Ste a-180
Plantation, FL 33324
Phone
(954) 587-4218
Fax
(954) 587-4219
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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 PA9110714 FL Primary

Addresses

Primary practice location

950 S Pine Island Rd Ste a-180
Plantation, FL 33324

Mailing address

950 S Pine Island Rd Ste a-180
Plantation, FL 33324-3918
Phone (954) 587-4218

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidFL

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
I20180221000915 FL Practitioner - Physician Assistant 8527329267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Sinus and Snoring Specialists, LLCGroup PAC ID 0547623209, 6 clinicians

Practice addresses (Care Compare)

1301 E Broward Blvd
Suite 240
Fort Lauderdale, FL 33301-2111
Phone (954) 983-1211

National Provider Directory

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

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": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1578076410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S PINE ISLAND RD STE A-180",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243918",
            "telephone_number": "954-587-4218",
            "fax_number": "954-587-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S PINE ISLAND RD STE A-180",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33324",
            "telephone_number": "954-587-4218",
            "fax_number": "954-587-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVNI",
        "first_name": "EDEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.