Individual provider Active NPI

Jose H Cerda, PA-C

  • Surgical Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1710022520
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9100628 Issued in FL
Practice address
1995 E Oakland Park Blvd Ste 250
Fort Lauderdale, FL 33306
Phone
(954) 791-6146
Fax
(954) 337-2733
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9100628 FL Primary

Addresses

Primary practice location

1995 E Oakland Park Blvd Ste 250
Fort Lauderdale, FL 33306

Mailing address

1995 E Oakland Park Blvd Ste 250
Ft Lauderdale, FL 33306-1149
Phone (954) 533-2350

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
I20130529000200 FL Practitioner - Physician Assistant 5597903831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Practitioners, LLCGroup PAC ID 1658688304, 63 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Fort Lauderdale, FL 33334-4149
Phone (954) 229-8635

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 987-2000

703 N Flamingo Rd
Memorial Hospital West
Pembroke Pines, FL 33028-1006
Phone (954) 436-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9100628FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ap of Nashville, LLC Surgical PastSince Oct 6, 2019 Accepting new patients

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 and National Provider Directory roles.

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1710022520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E OAKLAND PARK BLVD STE 250",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061149",
            "telephone_number": "954-533-2350",
            "fax_number": "954-337-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E OAKLAND PARK BLVD STE 250",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33306",
            "telephone_number": "954-791-6146",
            "fax_number": "954-337-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERDA",
        "first_name": "JOSE",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9100628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.