Individual provider Active NPI

Samara Vazquez, CAA

  • Anesthesiologist Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1750002499
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA743 Issued in FL
Practice address
1525 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1831
Phone
(800) 437-2672
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA743 FL Primary

Addresses

Primary practice location

1525 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1831

Mailing address

28501 SW 152ND Ave Lot 236
Homestead, FL 33033-1441
Phone (305) 528-9649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220929004070 FL Practitioner - Anesthesiology Assistant 3678959509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-5339

Hospital & facility affiliations

  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Current Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Sep 20, 2022 Accepting new patients
Sheridan Healthcorp Inc CurrentSince Sep 20, 2022 Accepting new patients

Locations

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 3

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 1

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": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1750002499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28501 SW 152ND AVE LOT 236",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330331441",
            "telephone_number": "305-528-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W CYPRESS CREEK RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091831",
            "telephone_number": "800-437-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "SAMARA",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.