Individual provider Active NPI

Daneshia Roberts-Pollack, PA-C

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1790057594
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9106416 Issued in FL
Practice address
7900 NW 27TH Ave Ste F3
Miami, FL 33147-4909
Phone
(305) 758-0591
NPI assigned
Feb 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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 PA 9106416 FL Primary

Addresses

Primary practice location

7900 NW 27TH Ave Ste F3
Miami, FL 33147-4909

Mailing address

12000 SW 12TH St
Pembroke Pines, FL 33025-3740
Phone (305) 724-2931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9106416FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics Urgent Care LLC Past Accepting new patients
Rozalyn Hester Paschal MD PA Past 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.

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1790057594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 SW 12TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330253740",
            "telephone_number": "305-724-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 NW 27TH AVE STE F3",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331474909",
            "telephone_number": "305-758-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS-POLLACK",
        "first_name": "DANESHIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9106416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.