Individual provider Active NPI

Tiffany K Truong, PA

  • Physician Assistant
  • Hollywood, FL
National Provider Identifier
1821727595
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115654 Issued in FL
Practice address
1150 N 35TH Ave Ste 650
Hollywood, FL 33021-5471
Phone
(954) 265-5969
Fax
(954) 965-3599
NPI assigned
Jun 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 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 PA9115654 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave Ste 650
Hollywood, FL 33021-5471

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

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
I20220907001779 FL Practitioner - Physician Assistant 2466836614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-9976

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115654FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince Jul 29, 2025 Accepting new patients
South Broward Hospital District CurrentSince Jun 16, 2022 Accepting new patients
South Broward Hospital District CurrentSince Jun 16, 2022 Accepting new patients

Locations

1150 N 35th Ave
Ste 650
Hollywood, FL 33021
Phone (954) 265-5969

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

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

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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.

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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1821727595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-276-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 650",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215471",
            "telephone_number": "954-265-5969",
            "fax_number": "954-965-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "TIFFANY",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.