Individual provider Active NPI

Alexander Mazekina Taira

  • Family Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1982061214
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9385407 Issued in FL
Practice address
300 NW 70TH Ave Ste 205
Plantation, FL 33317-2367
Phone
(954) 321-5428
Fax
(954) 583-0660
NPI assigned
Jan 18, 2016
Last updated
Sep 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9385407 FL Primary

Addresses

Primary practice location

300 NW 70TH Ave Ste 205
Plantation, FL 33317-2367

Mailing address

300 NW 70TH Ave Ste 205
Plantation, FL 33317-2367
Phone (954) 321-5428

Other practice location 1

710 Oak Commons Blvd
Kissimmee, FL 34741-4100
Phone (407) 846-6747

Other identifiers 1

IdentifierTypeStateIssuer
APRN9385407OtherFLAPRN

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
I20160404000761 FL Practitioner - Nurse Practitioner 7012214208 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9385407FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Satya P Singh MD PA CurrentSince Jul 8, 2019 Accepting new patients

Locations

300 NW 70th Ave
Ste 205
Plantation, FL 33317
Phone (954) 321-5428

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, 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": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1982061214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NW 70TH AVE STE 205",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172367",
            "telephone_number": "954-321-5428",
            "fax_number": "954-583-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NW 70TH AVE STE 205",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172367",
            "telephone_number": "954-321-5428",
            "fax_number": "954-583-0660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Oak Commons Blvd",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414100",
            "country_code": "US",
            "telephone_number": "407-846-6747",
            "fax_number": "407-846-6186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZEKINA TAIRA",
        "first_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-18",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9385407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "APRN9385407",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.