Individual provider Active NPI

Cristina Chaviano, P.A.

  • Medical Physician Assistant
  • Hialeah, FL
National Provider Identifier
1942482153
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102673 Issued in FL
Practice address
415 W 49TH St
Ste 1
Hialeah, FL 33012-3637
Phone
(305) 364-3404
Fax
(305) 364-3433
NPI assigned
Nov 29, 2007
Last updated
Feb 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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 PA9102673 FL Primary

Addresses

Primary practice location

415 W 49TH St
Ste 1
Hialeah, FL 33012-3637

Mailing address

415 W 49TH St
Ste 1
Hialeah, FL 33012-3637
Phone (305) 364-3404

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
I20150505002905 FL Practitioner - Physician Assistant 0345569877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2155 SE Federal Hwy
Wellmed at South Stuart
Stuart, FL 34994-4514
Phone (772) 223-9630

415 W 49TH St
Optum of Hialeah
Hialeah, FL 33012-3637
Phone (305) 364-3404

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9102673FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Finlay Optical, Inc. Past 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": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1942482153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W 49TH ST",
            "address_2": "STE 1",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123637",
            "telephone_number": "305-364-3404",
            "fax_number": "305-364-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W 49TH ST",
            "address_2": "STE 1",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123637",
            "telephone_number": "305-364-3404",
            "fax_number": "305-364-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVIANO",
        "first_name": "CRISTINA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.