Individual provider Active NPI

Mariana Berger, PA

  • Physician Assistant
  • Boynton Beach, FL
National Provider Identifier
1730560145
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108755 Issued in FL
Practice address
6080 W Boynton Beach Blvd
Number 100
Boynton Beach, FL 33437
Phone
(877) 412-7272
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 PA9108755 FL Primary

Addresses

Primary practice location

6080 W Boynton Beach Blvd
Number 100
Boynton Beach, FL 33437

Mailing address

6586 Hypoluxo Rd Ste 334
Lake Worth, FL 33467-7678
Phone (877) 412-7272

Other practice location 1

2000 Continental Dr Ste B
West Palm Beach, FL 33407-3207
Phone (561) 318-8440

Other identifiers 1

IdentifierTypeStateIssuer
01622410MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CameronSpineInstitue.BlaineCameron@130839.advancedmd-direct.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9108755FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Accountable Care Hospitalist Group CurrentSince Jun 1, 2019 Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Interoperability endpoints

  • Direct secure messaging: cameronspineinstitue.blainecameron@130839.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1730560145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6586 HYPOLUXO RD STE 334",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677678",
            "telephone_number": "877-412-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 W BOYNTON BEACH BLVD",
            "address_2": "NUMBER 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33437",
            "telephone_number": "877-412-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Continental Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334073207",
            "country_code": "US",
            "telephone_number": "561-318-8440",
            "fax_number": "855-436-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGER",
        "first_name": "MARIANA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2021-04-09",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01622410",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CameronSpineInstitue.BlaineCameron@130839.advancedmd-direct.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6586 Hypoluxo Rd Ste 334",
            "city": "Lake Worth",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334677678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.