Individual provider Active NPI

Shareen Lohse, PA-C

  • Physician Assistant
  • Plantation, FL
National Provider Identifier
1588676175
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9101490 Issued in FL
Practice address
8320 W Sunrise Blvd Ste 205
Plantation, FL 33322-5432
Phone
(800) 640-3451
NPI assigned
Aug 12, 2006
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 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 PA 9101490 FL Primary

Addresses

Primary practice location

8320 W Sunrise Blvd Ste 205
Plantation, FL 33322-5432

Mailing address

439 S Pleasant Grove Blvd Ste 3
Pleasant Grove, UT 84062-3493
Phone (800) 640-3451

Other names 1

  • Shareen Deblasis Former name

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
I20111219000659 FL Practitioner - Physician Assistant 1456526508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

8320 W Sunrise Blvd
Suite 208
Plantation, FL 33322-5432
Phone (800) 640-3451

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9101490FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skin and Cancer Associates PastSince Jun 30, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1588676175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 S PLEASANT GROVE BLVD STE 3",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623493",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 W SUNRISE BLVD STE 205",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225432",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOHSE",
        "first_name": "SHAREEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9101490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAREEN",
            "last_name": "DEBLASIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.