Individual provider Active NPI

Tatiana Idrobo, MPAS, PA-C

  • Physician Assistant
  • Wellington, FL
National Provider Identifier
1972301372
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10111 Forest Hill Blvd RM 100
Wellington, FL 33414-6141
Phone
(561) 798-1649
Fax
(561) 791-8631
NPI assigned
Mar 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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 FL Primary

Addresses

Primary practice location

10111 Forest Hill Blvd RM 100
Wellington, FL 33414-6141

Mailing address

10111 Forest Hill Blvd RM 100
Wellington, FL 33414-6141
Phone (561) 798-1649

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
I20250711000956 FL Practitioner - Physician Assistant 4688189541 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1972301372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 FOREST HILL BLVD RM 100",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146141",
            "telephone_number": "561-798-1649",
            "fax_number": "561-791-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 FOREST HILL BLVD RM 100",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146141",
            "telephone_number": "561-798-1649",
            "fax_number": "561-791-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDROBO",
        "first_name": "TATIANA",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.