Individual provider Active NPI

Nicole Alexandra Heitz, PA-C

  • Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1639719537
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
500 N Hiatus Rd Ste 101
Pembroke Pines, FL 33026-5213
Phone
(954) 438-7171
Fax
(954) 438-1411
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 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 Primary

Addresses

Primary practice location

500 N Hiatus Rd Ste 101
Pembroke Pines, FL 33026-5213

Mailing address

15280 NW 79TH CT Ste 200
Miami Lakes, FL 33016-5873
Phone (305) 558-3724

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicolepalmero@sfa.allscriptsdirect.net Florida ENT Associates, Inc.

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
I20230425001029 FL Practitioner - Physician Assistant 2961867072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida ENT Associates IncGroup PAC ID 4587556923, 156 clinicians

Practice addresses (Care Compare)

500 N Hiatus Rd
Suite 101
Pembroke Pines, FL 33026-5213
Phone (954) 438-7171

8940 N Kendall Dr
Suite 504E
Miami, FL 33176-2150
Phone (305) 595-6200

Merit-based Incentive Payment System (MIPS)

Final score
70.4 of 100Reported as group
Quality
47.82
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida ENT Associates, Inc. CurrentSince Apr 17, 2023 Accepting new patients
Carla Lucacel MD PC PastSince Jan 1, 2020 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Past Accepting new patients

Locations

8940 N Kendall Dr
Ste 504E
Miami, FL 33176
Phone (305) 595-6200

15280 NW 79th Ct
Ste 200
Miami Lakes, FL 33016

500 N Hiatus Rd
Ste 101
Pembroke Pines, FL 33026
Phone (954) 381-8989

18501 Pines Blvd
Ste 210
Pembroke Pines, FL 33029
Phone (954) 237-2505

Interoperability endpoints

  • Direct secure messaging: nicolepalmero@sfa.allscriptsdirect.net

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": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1639719537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N HIATUS RD STE 101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265213",
            "telephone_number": "954-438-7171",
            "fax_number": "954-438-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZ",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicolepalmero@sfa.allscriptsdirect.net",
            "affiliation": "Y",
            "affiliationName": "Florida ENT Associates, Inc.",
            "address_1": "500 N Hiatus Rd Ste 101",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330265213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.