Active NPI
Miriam Isaacoff
- Physician Assistant
- Tampa, FL
National Provider Identifier
1992105159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 017913
- Practice address
- 4730 N Habana Ave Ste 206
Tampa, FL 33614-7148 - Phone
- (954) 231-3080
- NPI assigned
- Aug 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 017913 | NY | Primary |
Addresses
Primary practice location
4730 N Habana Ave Ste 206
Tampa, FL 33614-7148
Mailing address
4730 N Habana Ave Ste 206
Tampa, FL 33614-7148
Phone (954) 231-3080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017913 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017913 | NY | MD | Physician Assistant |
Interoperability endpoints
- miriam.isaacoff@597174495543300.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1992105159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4730 N HABANA AVE STE 206",
"city": "TAMPA",
"state": "FL",
"postal_code": "336147148",
"telephone_number": "954-231-3080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4730 N HABANA AVE STE 206",
"city": "TAMPA",
"state": "FL",
"postal_code": "336147148",
"telephone_number": "954-231-3080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAACOFF",
"first_name": "MIRIAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-25",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "017913",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "017913",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.