Individual provider Active NPI

Jessica Bastos Oliveira, MSPA, PA-C

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1649465857
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109706 Issued in FL
Practice address
11200 SW 8 Street
Green Library, Room 475
Miami, FL 33199-3319
Phone
(917) 495-1632
Fax
(917) 495-1632
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0119001 NY
Physician Assistant 363A00000X PA9109706 FL Primary

Addresses

Primary practice location

11200 SW 8 Street
Green Library, Room 475
Miami, FL 33199-3319

Mailing address

7421 SW 163Rd CT
Miami, FL 33193-4422
Phone (917) 495-1632

Other practice location 1

800 SW 108th Ave
Miami, FL 33174-2555
Phone (917) 495-1632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0119001NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jessica.oliveira.1@27920.direct.athenahealth.com
  • Direct secure messaging: jessica.oliveira.1@14931.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649465857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 SW 163RD CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331934422",
            "telephone_number": "917-495-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 SW 8 STREET",
            "address_2": "GREEN LIBRARY, ROOM 475",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331993319",
            "telephone_number": "917-495-1632",
            "fax_number": "917-495-1632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 SW 108th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331742555",
            "country_code": "US",
            "telephone_number": "917-495-1632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVEIRA",
        "first_name": "JESSICA",
        "middle_name": "BASTOS",
        "credential": "MSPA, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0119001",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.