Individual provider Active NPI

Oksana Maltseva, PA

  • Physician Assistant
  • Sunny Isles Beach, FL
National Provider Identifier
1578801536
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107075 Issued in FL
Practice address
19390 Collins Ave
Suite 1104
Sunny Isles Beach, FL 33160-2200
Phone
(305) 283-8370
NPI assigned
Jan 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

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 PA9107075 FL Primary

Addresses

Primary practice location

19390 Collins Ave
Suite 1104
Sunny Isles Beach, FL 33160-2200

Mailing address

19390 Collins Ave Apt 1510
Sunny Isles Beach, FL 33160-2277
Phone (305) 283-8370

Other identifiers 1

IdentifierTypeStateIssuer
PA9107075OtherFLPHYSICIAN ASSISTANT LICENSE

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
I20150216001270 FL Practitioner - Physician Assistant 7315262326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Local Specialty Care IncGroup PAC ID 3971591231, 29 clinicians

Practice addresses (Care Compare)

2500 E Hallandale Beach Blvd
Suite 301
Hallandale Beach, FL 33009-4835
Phone (954) 458-2572

5355 Lyons Rd
Coconut Creek, FL 33073-2825
Phone (954) 570-9595

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9107075FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Drive Physicians Past Accepting new patients
Mel-Bay Health Care Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJGBDA

Organizations & group practices 3

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": "1359244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1578801536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19390 COLLINS AVE APT 1510",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331602277",
            "telephone_number": "305-283-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19390 COLLINS AVE",
            "address_2": "SUITE 1104",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331602200",
            "telephone_number": "305-283-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALTSEVA",
        "first_name": "OKSANA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-27",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "PA9107075",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunny Isles Beach, FL

Sources for this page

Verify at the official NPI Registry.