Active NPI
Traci Celeste Diphillippo, PA-C
- Physician Assistant
- Hollywood, FL
National Provider Identifier
1841543063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9107681
- Practice address
- 4060 Sheridan St Ste C
Hollywood, FL 33021-3559 - Phone
- (954) 987-7512
- Fax
- (954) 987-3977
- NPI assigned
- Oct 25, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9107681 | FL | Primary |
Addresses
Primary practice location
4060 Sheridan St Ste C
Hollywood, FL 33021-3559
Mailing address
2235 Venetian Court
Suite 1
Naples, FL 34109-8728
Phone (239) 596-9337
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2235 Venetian CT
Suite 1
Naples, FL 34109-8728
Phone 2395969337610
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9107681 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norman Minars, 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.
-
- Specialist
- Hollywood, FL
- NPI 1831186170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1841543063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2235 VENETIAN COURT",
"address_2": "SUITE 1",
"city": "NAPLES",
"state": "FL",
"postal_code": "341098728",
"telephone_number": "239-596-9337",
"fax_number": "239-596-9466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 SHERIDAN ST STE C",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213559",
"telephone_number": "954-987-7512",
"fax_number": "954-987-3977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIPHILLIPPO",
"first_name": "TRACI",
"middle_name": "CELESTE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-25",
"last_updated": "2025-05-09",
"certification_date": "2024-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9107681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.