Individual provider Active NPI

Horacio Garcia Oconnor, P.A.

  • Surgical Physician Assistant
  • Davie, FL
National Provider Identifier
1639238413
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9100799 Issued in FL
Practice address
8121 Bermuda Point LN
Davie, FL 33328-3023
Phone
(954) 475-4615
NPI assigned
Dec 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9100799 FL Primary

Addresses

Primary practice location

8121 Bermuda Point LN
Davie, FL 33328-3023

Mailing address

8121 Bermuda Point LN
Davie, FL 33328-3023
Phone (954) 475-4615

Other identifiers 1

IdentifierTypeStateIssuer
290871900MedicaidFL

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
I20060428000019 FL Practitioner - Physician Assistant 3072523588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialtycare Surgical Assist, LLCGroup PAC ID 3274446497, 33 clinicians

Practice addresses (Care Compare)

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (305) 682-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9100799FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Surg Med Assistants Surgical Past Accepting new patients
Surg Med of Northshore Surgical Past Accepting new patients

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.

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": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1639238413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 BERMUDA POINT LN",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333283023",
            "telephone_number": "954-475-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 BERMUDA POINT LN",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333283023",
            "telephone_number": "954-475-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA OCONNOR",
        "first_name": "HORACIO",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9100799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290871900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.