Jacqueline Marie Small, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9103968 Issued in FL

Practice address

6015 NW 7TH Ave
Miami, FL 33127-1109

Phone

(305) 756-5502

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

DRT Behavioral Services PLLCGroup PAC ID 7911148325, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• DRT Behavioral Services PLLC

  • Psychiatry Physician
  • Fort Lauderdale, FL
  • NPI 1063856938
  Medicare reassignment Care Compare group
• Jacque' Inc

  • Physician Assistant
  • Oakland Park, FL
  • NPI 1073274171
  NPD Authorized official

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700939410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 NW 103RD ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331501236",
            "telephone_number": "786-443-4313",
            "fax_number": "305-762-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 NW 7TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331271109",
            "telephone_number": "305-756-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Small Change Therapy, PLLC
• Small Giants Therapy Corp
• Small Moments L.L.C
• Small Steps of the Mind LLC
• Dorrel Small, CRNA
• Leslie Rebecca Small, O.D.
• Raquel Josephine Small, ARNP
• Smart ABA Services Corp
• Smart Choice Med Center, Corp
• Smart Kids Club Therapy Services LLC

• Medical Physician Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.