Individual provider Active NPI

Mariana Ernestina Kaviany

  • Physician Assistant
  • Wellington, FL
National Provider Identifier
1801285697
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108542 Issued in FL
Practice address
10520 Forest Hill Blvd
Wellington, FL 33414-3179
Phone
(561) 204-9355
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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 PA9108542 FL Primary

Addresses

Primary practice location

10520 Forest Hill Blvd
Wellington, FL 33414-3179

Mailing address

3100 SW 62ND Ave
Miami, FL 33155-3009

Other practice location 1

3100 SW 62nd Ave
Miami, FL 33155-3009
Phone (786) 624-3588

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
I20170322002188 FL Practitioner - Physician Assistant 7416232038 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Outpatient Services Inc CurrentSince Mar 1, 2021 Accepting new patients
MD Now Medical Centers Inc CurrentSince Oct 13, 2020 Accepting new patients

Locations

6264 W Sample Rd
Ste 120
Coral Springs, FL 33067
Phone (954) 837-1020

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

8950 SW 88th St
Miami, FL 33176
Phone (305) 271-8950

8950 N Kendall Dr
Fl 2
Miami, FL 33176
Phone (786) 596-7200

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

Interoperability endpoints

  • Direct secure messaging: mkaviany20158@jupitermedicalcenter.direct-ci.com

Organizations & group practices 4

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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1801285697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143179",
            "telephone_number": "561-204-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331553009",
            "country_code": "US",
            "telephone_number": "786-624-3588",
            "fax_number": "305-662-8291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVIANY",
        "first_name": "MARIANA",
        "middle_name": "ERNESTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.