Individual provider Active NPI

Derek Lawrence Urquiza

  • Anesthesiologist Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1649991498
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA750 Issued in FL
Practice address
1525 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1831
Phone
(800) 437-2672
NPI assigned
Sep 9, 2022
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA750 FL Primary

Addresses

Primary practice location

1525 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1831

Mailing address

501 NW 88TH Ave
Pembroke Pines, FL 33024-6527
Phone (954) 614-0710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221021001167 FL Practitioner - Anesthesiology Assistant 1759757370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

1901 SW 172 Ave
Miramar, FL 33029-5592
Phone (954) 538-4600

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-5339

3600 Washington St
Hollywood, FL 33021-8216
Phone (954) 265-5339

401 NW 42ND Ave
Plantation, FL 33317-2835
Phone (954) 587-5010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA750FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc CurrentSince Sep 22, 2022 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Sep 22, 2022 Accepting new patients
Sheridan Healthcorp Inc Current Accepting new patients

Locations

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1649991498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 NW 88TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246527",
            "telephone_number": "954-614-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W CYPRESS CREEK RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091831",
            "telephone_number": "800-437-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URQUIZA",
        "first_name": "DEREK",
        "middle_name": "LAWRENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.