Individual provider Active NPI

Eileen Jo-Anne Davidson

  • Physician Assistant
  • North Miami Beach, FL
National Provider Identifier
1649820424
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9112461 Issued in FL
Practice address
16470 NE 10TH Ave
North Miami Beach, FL 33162-3710
Phone
(305) 651-9988
NPI assigned
Sep 13, 2019
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 PA9112461 FL Primary

Addresses

Primary practice location

16470 NE 10TH Ave
North Miami Beach, FL 33162-3710

Mailing address

1898 Silverbell Ter
Weston, FL 33327-2362
Phone (954) 804-5628

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
I20200122001495 FL Practitioner - Physician Assistant 2264867274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabclinics Pta IncGroup PAC ID 0547237497, shared by 11 NPIs, 209 clinicians
Scott R English MD PAGroup PAC ID 5991699514, 5 clinicians

Practice addresses (Care Compare)

13645 Biscayne Blvd
North Miami Beach, FL 33181-1617
Phone (305) 949-2700

16470 NE 10TH Ave
North Miami Beach, FL 33162-3710
Phone (305) 651-9988

2209 N University Dr
Pembroke Pines, FL 33024-3611
Phone (954) 966-5701

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9112461FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott R English MD PA Family Medicine CurrentSince Oct 23, 2019 Accepting new patients
Knock Your Socks Off Foot & Ankle Specialist LLC Past Accepting new patients

Locations

16470 NE 10th Ave
North Miami Beach, FL 33162
Phone (305) 651-9988

2209 N University Dr
Pembroke Pines, FL 33024
Phone (954) 966-5700

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1649820424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1898 SILVERBELL TER",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333272362",
            "telephone_number": "954-804-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16470 NE 10TH AVE",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623710",
            "telephone_number": "305-651-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "EILEEN",
        "middle_name": "JO-ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.