PA SURGICAL INC (NPI# 1942313879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942313879 |
| Entity Type | Organization |
| Organization Name | PA SURGICAL INC |
| Practice Address |
621 Nw 53rd St Ste 330 Boca Raton FL 33487-8281 |
| Practice Telephone | 5614407612 |
| Practice Fax Number | 8669028817 |
| Mailing Telephone | 8004880279 |
| Mailing Fax Number | 8669028817 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | NANCY T BOURG (CEO) |
| Authorized Official Telephone | 5618891227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS PROVIDER NUMBER | X1578 | 01 |
| Street Address |
621 NW 53RD ST STE 330 |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33487-8281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679124861 | Mary Ann Kogan | Physician Assistant | 621 Nw 53rd St Ste 330, Boca Raton, FL 33487-8281 | 2019-09-27 |
| 1326691569 | Connorie Jeane Murray | Physician Assistant | 621 Nw 53rd St Ste 330, Boca Raton, FL 33487-8281 | 2019-07-17 |
| 1417485053 | Prohealth Select, Inc. | Clinic/Center | 621 Nw 53rd St Ste 330, Boca Raton, FL 33487-8281 | 2017-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386261741 | Kendall Hackenberg | Nurse Practitioner | 810 Nw 82nd Pl, Boca Raton, FL 33487 | 2020-07-01 |
| 1275187015 | Trusted Home Care Agency | Home Health | 1200 S. Rogers Circle, Suite #4, Boca Raton, FL 33487 | 2019-07-30 |
| 1972064475 | West Palm Beac Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 902 Clint Moore Road, Ste 144, Boca Raton, FL 33487 | 2019-03-27 |
| 1386153807 | Michael Christopher Angelillo | Internal Medicine | 1601 Clint Moore Rd Ste 115, Boca Raton, FL 33487 | 2017-09-27 |
| 1942729645 | Ronald Falk | Chiropractor | 6201 N Federal Hwy #5-6, Boca Raton, FL 33487 | 2017-09-13 |
| 1205292653 | Abigail Goodwin Sladek | Nurse Practitioner | 902 Clint Moore Rd # 227, Boca Raton, FL 33487 | 2016-01-14 |
| 1538539879 | Nancy Gonzalez | Dental Hygienist | 904 Clint Moore Rd, Boca Raton, FL 33487 | 2015-09-29 |
| 1083090138 | John Hooper Griscom | Internal Medicine | 3752 Mykonos Court, Boca Raton, FL 33487 | 2015-07-30 |
| 1144600321 | Hear Again LLC | Audiologist-Hearing Aid Fitter | 851 Broken Sound Pkwy Nw Ste 120, Boca Raton, FL 33487 | 2015-06-03 |
| 1457759193 | Element Lab Partners, LLC | Clinical Medical Laboratory | 1101 Holland Dr., Ste. 30, Boca Raton, FL 33487 | 2014-12-11 |
| Find all providers in zip 33487 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730665522 | Prissy Graciela Rampaly Rangel | Physician Assistant | 23090 Post Gardens Way Apt 307, Boca Raton, FL 33433 | 2018-07-14 |
| 1891095196 | Maria Fernanda Konieczko | Physician Assistant | 9135 Saddlecreek Dr, Boca Raton, FL 33496-1892 | 2010-11-02 |
| 1962529800 | Kathleen A Duffy | Physician Assistant | 1211 Nw 15th St, Boca Raton, FL 33486-1204 | 2007-03-24 |
| 1861541096 | Michele A. Mysnyk-deangelo | Physician Assistant | 951 Broken Sound Pkwy Ste 115, Boca Raton, FL 33487-3531 | 2007-01-09 |
| 1881762573 | Craig Sprenger | Physician Assistant | 1398 Sw 18th St, Boca Raton, FL 33486-6634 | 2006-12-01 |
| 1891801171 | Charles Jacob Strader Jr. | Physician Assistant | 621 Nw 53rd St, Suite 330, Boca Raton, FL 33487 | 2006-08-21 |
| 1134764830 | Unidad De La Mujer LLC | Physician Assistant | 23090 Post Gardens Way Apt 307, Boca Raton, FL 33433-5666 | 2019-11-18 |
| 1881049302 | Ashley Lelchuk | Physician Assistant | 670 Glades Rd, Suite #300, Boca Raton, FL 33431-6461 | 2016-05-03 |
| 1174992465 | Matthew Earhart | Physician Assistant | 7301a W Palmetto Park Rd, #100b, Boca Raton, FL 33433-3409 | 2015-09-17 |
| 1578804183 | Ronald Jay Kerble | Physician Assistant | 825 Meadows Rd, Suite #111, Boca Raton, FL 33486 | 2013-03-06 |
| Find all providers in BOCA RATON | ||||
| City | BOCA RATON |
| Zip Code | 33487 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.