Individual provider Active NPI

Gerarda Tamara Lascaze, PA-C MMS

  • Advanced Practice Midwife
  • Miami Shores, FL
National Provider Identifier
1821423575
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
PA 9107294 Issued in FL
Practice address
9730 NE 2ND Ave
Miami Shores, FL 33138-2311
Phone
(305) 758-7979
Fax
(305) 758-0034
NPI assigned
Sep 12, 2013
Last updated
Sep 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X PA 9107294 FL Primary

Addresses

Primary practice location

9730 NE 2ND Ave
Miami Shores, FL 33138-2311

Mailing address

1425 NE 137TH St
North Miami, FL 33161-3513
Phone (786) 406-4486

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
I20140710001205 FL Practitioner - Physician Assistant 7618192451 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA 9107294FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Specialist Doctors Group LLC CurrentSince Apr 19, 2014 Accepting new patients

Locations

210 N Alexander St
Plant City, FL 33563
Phone (813) 719-3525

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1821423575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 NE 137TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331613513",
            "telephone_number": "786-406-4486",
            "fax_number": "305-758-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 NE 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382311",
            "telephone_number": "305-758-7979",
            "fax_number": "305-758-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASCAZE",
        "first_name": "GERARDA",
        "middle_name": "TAMARA",
        "name_prefix": "Miss",
        "credential": "PA-C MMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "PA 9107294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

Verify at the official NPI Registry.