Individual provider Active NPI

Bruna Patricia Purgato Dantas, PA-C

  • Medical Physician Assistant
  • Oakland Park, FL
National Provider Identifier
1871915645
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9107610 Issued in FL
Practice address
1421 E Oakland Park Blvd Ste 200
Oakland Park, FL 33334-4434
Phone
(954) 565-0875
Fax
(954) 565-0876
NPI assigned
Jan 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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 PA9107610 FL Primary

Addresses

Primary practice location

1421 E Oakland Park Blvd Ste 200
Oakland Park, FL 33334-4434

Mailing address

1421 E Oakland Park Blvd Ste 200
Oakland Park, FL 33334-4434
Phone (954) 565-0875

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
I20150106001435 FL Practitioner - Physician Assistant 8921321555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midland Medical Broward LLCGroup PAC ID 3274638549, 10 clinicians

Practice addresses (Care Compare)

1421 E Oakland Park Blvd
Suite 200
Oakland Park, FL 33334-4434
Phone (954) 565-0875

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9107610FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Cares Inc CurrentSince Sep 25, 2022 Accepting new patients

Locations

1421 E Oakland Park Blvd
Ste 200
Oakland Park, FL 33334
Phone (954) 375-1276

Interoperability endpoints

  • Direct secure messaging: bruna.dantaspac.p1@direct.arapb.nextgenshare.com

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.

Hospital & facility affiliations 4

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": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1871915645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E OAKLAND PARK BLVD STE 200",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344434",
            "telephone_number": "954-565-0875",
            "fax_number": "954-565-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E OAKLAND PARK BLVD STE 200",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344434",
            "telephone_number": "954-565-0875",
            "fax_number": "954-565-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURGATO DANTAS",
        "first_name": "BRUNA",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

Verify at the official NPI Registry.