Ilda Y Isaza, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS8963 Issued in FL

Practice address

101 Bodin Cir Unit 777
Travis Afb, CA 94535-1809

Phone

(707) 423-3730

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• East Florida Primary Care LLC

  • Family Medicine Physician
  • Sunrise, FL
  • NPI 1811121205
  Medicare reassignment NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1871512913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR UNIT 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR UNIT 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAZA",
        "first_name": "ILDA",
        "middle_name": "Y",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U3372W",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Andrew Hussey, PHARMD
• Daniel Hutchinson, DO
• Paul Hutchinson, M.D.
• George Da-Chang Hwang, DDS
• Laura Lea Ibanez, BSN, RN
• Mary Issitt, IDMT
• Nicole Ivy-Kutzler, WHNP
• Joshua Izenbart, DPT
• Tyler Jackson, LCSW
• Isaac Daniel James Jr., IDMT

• Family Medicine Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.