VITIA ANGELA PACK (PA-C) – Physician Assistant, NPI 1013133826
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for VITIA ANGELA PACK (PA-C)
4780 SW 64TH AVE STE 103
DAVIE, FL 333144400
Phone: (954) 434-1705
Fax: (954) 434-1882
Type: Mailing
4780 SW 64TH AVE STE 101
DAVIE, FL 333144400
Phone: (954) 434-1705
Fax: (954) 434-1882
Type: Location
6101 BLUE LAGOON DR STE 400
MIAMI, FL 331262051
Phone: (305) 500-2000
Fax: (786) 515-9308
Type: Mailing
17160 ROYAL PALM BLVD STE 2
WESTON, FL 333262395
Phone: (954) 762-6440
Fax: (800) 618-2120
Type: Location
49 HOSIERY MILL RD STE 124
DALLAS, GA 301571688
Phone: (770) 443-6111
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $431.
Total Amount is formed as General ($431) + Research ($0) + Ownership ($0) = $431.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Lilly USA, LLC ($156).
Total Amount
$431
General + Research + Ownership
Payments
16
Total payment records
General Amount
$431
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $156 |
| Exact Sciences Corporation | $127 |
| Novo Nordisk Inc | $67 |
| ABBVIE INC. | $37 |
| Abbott Laboratories | $29 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120731000252 | I | Physician Assistant | FL | TBD |
| I20240517001067 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33314)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Internal Medicine | GA | |
| Nurse Practitioner | GA | |
| Family Practice | LA | |
| Nurse Practitioner | GA | |
| Family Practice | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine | VA | |
| Family Practice | GA | |
| Nurse Practitioner | GA |
Reviews
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