Individual provider Active NPI

Nicole Bowers

  • Medical Physician Assistant
  • Boca Raton, FL
National Provider Identifier
1831667971
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9111301 Issued in FL
Practice address
670 Glades Rd Ste 200
Boca Raton, FL 33431-6464
Phone
(561) 495-9511
NPI assigned
Nov 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 9111301 FL Primary

Addresses

Primary practice location

670 Glades Rd Ste 200
Boca Raton, FL 33431-6464

Mailing address

670 Glades Rd Ste 200
Boca Raton, FL 33431-6464

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
I20190131001292 FL Practitioner - Physician Assistant 6709123516 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9111301FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Florida, LLC CurrentSince Nov 1, 2018 Accepting new patients
Ortho Florida, LLC CurrentSince Nov 1, 2018 Accepting new patients

Locations

660 Glades Rd
Ste 460
Boca Raton, FL 33431
Phone (561) 300-1792

1601 Clint Moore Rd
Ste 125
Boca Raton, FL 33487
Phone (561) 395-5733

751 Park of Commerce Dr
Ste 112
Boca Raton, FL 33487
Phone (561) 300-1779

670 Glades Rd
Ste 200
Boca Raton, FL 33431
Phone (561) 391-6470

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": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1831667971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 GLADES RD STE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 GLADES RD STE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316464",
            "telephone_number": "561-495-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9111301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.