Active NPI
Kimberly Ann Monahan, PA-C
- Physician Assistant
- Hollywood, FL
National Provider Identifier
1902132145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9105208
- Practice address
- 3440 Hollywood Blvd.
Suite 460
Hollywood, FL 33021 - Phone
- (954) 923-7440
- Fax
- (954) 923-1299
- NPI assigned
- Oct 22, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9105208 | FL | |
| Physician Assistant | 363A00000X | PA9105208 | FL | Primary |
Addresses
Primary practice location
3440 Hollywood Blvd.
Suite 460
Hollywood, FL 33021
Mailing address
3440 Hollywood Blvd.
Suite 460
Hollywood, FL 33021
Phone (954) 923-7440
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9105208 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health Inc | Past | Accepting new patients |
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.
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- Pediatric Anesthesiology Physician
- Orlando, FL
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1902132145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3440 HOLLYWOOD BLVD.",
"address_2": "SUITE 460",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "954-923-7440",
"fax_number": "954-923-1299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 HOLLYWOOD BLVD.",
"address_2": "SUITE 460",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "954-923-7440",
"fax_number": "954-923-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONAHAN",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-22",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9105208",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9105208",
"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 Sep 2, 2016; 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.