Individual provider Active NPI

Carmen Somarriba, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1932602620
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111038 Issued in FL
Practice address
8083 Arctic Fox Rd
Jacksonville, FL 32222-4193
Phone
(954) 288-5911
NPI assigned
Mar 9, 2018
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111038 FL Primary

Addresses

Primary practice location

8083 Arctic Fox Rd
Jacksonville, FL 32222-4193

Mailing address

8083 Arctic Fox Rd
Jacksonville, FL 32222-4193

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
I20190226002221 FL Practitioner - Physician Assistant 4789923392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobile Visiting Practitioners, LLCGroup PAC ID 7810239100, 25 clinicians

Practice addresses (Care Compare)

140 S Beach St
Suite 202
Daytona Beach, FL 32114-4409
Phone (888) 506-8836

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services of Florida LLC PastSince Sep 15, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1932602620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8083 ARCTIC FOX RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322224193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8083 ARCTIC FOX RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322224193",
            "telephone_number": "954-288-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMARRIBA",
        "first_name": "CARMEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.