Individual provider Active NPI

Elle Cardone

  • Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1730540857
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109157 Issued in FL
Practice address
1411 N Flagler Dr
West Palm Beach, FL 33401-3404
Phone
(561) 262-0084
NPI assigned
Mar 17, 2016
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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 PA9109157 FL Primary

Addresses

Primary practice location

1411 N Flagler Dr
West Palm Beach, FL 33401-3404

Mailing address

4290 Professional Center Drive #301
Palm Beach Gardens, FL 33410

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@supriyamd.com Direct

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
I20161217000263 FL Practitioner - Physician Assistant 5294015855 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9109157FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: info@supriyamd.com

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": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1730540857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 PROFESSIONAL CENTER DRIVE #301",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-262-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONE",
        "first_name": "ELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@supriyamd.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1411 N Flagler Dr",
            "city": "West Palm Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334013404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.