Mary Ann Frances Coatoam, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9102357 Issued in FL

Practice address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone

(386) 425-4100

Fax

(386) 258-4875

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mary Ann Frances Boro Other name

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

State licenses

Practice roles

Locations

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.

• Central Florida Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1740251883

  FL

  Medicare reassignment
• Central Florida Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Sanford, FL
  • NPI 1396746988
  NPD
• Central Florida Family Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Sanford, FL
  • NPI 1255005476
  NPD
• Center for Sleep and Lung Disorders Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Lady Lake, FL
  • NPI 1982738738
  NPD (past)
• Central Florida Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Enterprise, FL
  • NPI 1447935622
  NPD (past)
• Central Florida Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1649241704
  NPD (past)
• Emmanuel Christian Health Center PA

  • Internal Medicine Physician
  • Lady Lake, FL
  • NPI 1750499943
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1649347147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22266",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154473",
            "telephone_number": "386-226-4590",
            "fax_number": "386-226-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-4100",
            "fax_number": "386-258-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COATOAM",
        "first_name": "MARY ANN",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9102357",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291742400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "BORO",
            "middle_name": "FRANCES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Ann Coady, M.D.
• Coast Florida P.a.
• Coastal Center Operations LLC
• Coastal Mental Health Center Inc
• Coastal Spine and Sport of Daytona Beach
• David Michael Coe, MD
• Janel Irene Coffing, ARNP
• Brenda Martin Cohen, ARNP
• Ethan Nathaniel Cohen, M.D.
• Hezi Cohen, M.D,

• All providers in Daytona Beach, FL
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.