Renee Ali-Samhoul, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

819 University Blvd Apt 206
Jupiter, FL 33458-3063

Phone

(954) 778-8300

NPI assigned

Sep 5, 2021

Sex

Female

Sole proprietor

Yes

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.

• New Age Dermatology Inc

  • Dermatology Physician
  • West Palm Beach, FL
  • NPI 1962586586

  FL

  Medicare reassignment

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2021.

{
    "created_epoch": "1630800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1629746482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 UNIVERSITY BLVD",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 UNIVERSITY BLVD APT 206",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583063",
            "telephone_number": "954-778-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI-SAMHOUL",
        "first_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-05",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gigi Monique Alexander, MBA, MSW, LCSW
• David Robert Alfieri, PHARMD
• Hiran Alejandro Alfonso, APRN-C
• Meryen Alfonso
• Khaled Algashaamy, M.D.
• Alice E Richman
• Dayna Alkins
• All Women'S Healthcare of West Broward, Inc.
• All Women'S Healthcare, Inc
• All Womens Healthcare Inc

• All providers in Jupiter, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.