Individual provider Active NPI

Nathali Eiranova, PA-C

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1689204729
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
12600 SW 120TH St Ste 113
Miami, FL 33186-9116
Phone
(305) 971-1210
Fax
(305) 971-7710
NPI assigned
Jan 16, 2020
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 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

12600 SW 120TH St Ste 113
Miami, FL 33186-9116

Mailing address

12600 SW 120TH St Ste 113
Miami, FL 33186-9116
Phone (305) 971-1210

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
I20220722002321 FL Practitioner - Physician Assistant 4981085826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Dermatology Group, Inc.Group PAC ID 7618026253, 8 clinicians

Practice addresses (Care Compare)

12600 SW 120TH St
Suite 113
Miami, FL 33186-9116
Phone (305) 971-1210

401 Coral Way
Suite 207
Coral Gables, FL 33134-4924
Phone (305) 445-2941

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Dermatology Associates, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nathalieiranova@dermatologyofsouthflorida.emadirect.md

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1689204729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 SW 120TH ST STE 113",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331869116",
            "telephone_number": "305-971-1210",
            "fax_number": "305-971-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 SW 120TH ST STE 113",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331869116",
            "telephone_number": "305-971-1210",
            "fax_number": "305-971-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIRANOVA",
        "first_name": "NATHALI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.