Oceanside Elite Surgical Assisting, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

OCEANSIDE ELITE SURGICAL ASSISTING, LLC

Practice address

3319 NE 15TH CT
Fort Lauderdale, FL 33304-1709

Phone

(954) 257-7859

Fax

(954) 616-8063

NPI assigned

Apr 21, 2019

Organization subpart

No

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

Authorized official

Name

Shelby Allison Lane, PA-CNPI 1710230651

Title

President

Phone

(954) 257-7859

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shelby A Lane, PA-C

  • Surgical Physician Assistant
  • Fort Lauderdale, FL
  • NPI 1710230651
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1555804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1780247189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 NE 15TH CT",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041709",
            "telephone_number": "954-257-7859",
            "fax_number": "954-616-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 NE 15TH CT",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041709",
            "telephone_number": "954-257-7859",
            "fax_number": "954-616-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEANSIDE ELITE SURGICAL ASSISTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-21",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "ALLISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-257-7859",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ocean Chemist LLC
• Ocean Health Care Group
• Ocean Health Center
• Ocean Sky Wellness, LLC
• Oceanside Audiology & Hearing LLC
• Oceanside Orthodontics PA
• Roni Romeo Tumalon Ocubillo, OTR
• Robert Leslie Odell, M.D.
• Jordan Oehler
• Carline Ofelus

• Surgical Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.