Krishna Vattamparambil, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111159 Issued in FL

Practice address

3349 NE 33Rd St Ste B
Fort Lauderdale, FL 33308

Phone

(954) 909-4998

NPI assigned

Oct 9, 2019

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• LQV Lauderdale Beach LLC

  • Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1891269239
  NPD (past)

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922640143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 NE 33RD ST STE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087111",
            "telephone_number": "954-909-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 NE 33RD ST STE B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-909-4998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18205 Biscayne Blvd Ste 2222",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331602148",
            "country_code": "US",
            "telephone_number": "786-629-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VATTAMPARAMBIL",
        "first_name": "KRISHNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "PA9111159",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Vasquez
• Lizette M Vasquez, COTA
• Boris Vasserman
• Amy H Vastine
• Delvia George Vathielil
• Lianis Vazquez Padron
• Patricia Ivelisse Vazquez Rosado
• Karen Denisse Vazquez Santiago
• Chelssia Marie Vazquez, MD
• Isa Vazquez, ARNP

• Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.