LILIAN DANIELA MAIRENA (PA) – Physician Assistant, NPI 1114748548

LILIAN DANIELA MAIRENA (PA) is a healthcare provider. based in Stuart, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. PA9119460 (FL). The NPI Number for LILIAN DANIELA MAIRENA (PA) is 1114748548

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
LILIAN DANIELA MAIRENA (PA)
NPI
1114748548
Phone
(772) 446-7209
Address
2221 SE Ocean Blvd Ste 200
Enumeration Date
18 October 2024
Last Update Date
18 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
77233553002015
Graduation Year
2024 (2 years ago)
PAC ID
6709310659
Group Practice PAC ID
5294728465
Professional Enrollment ID
I20241114001692
Address ID
FL349522320PO7710X1XXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for LILIAN DANIELA MAIRENA (PA)

  • 2221 SE Ocean Blvd Ste 200

    Stuart, FL 349963341

    Phone: (772) 446-7209

    Fax: (772) 200-2131

    Type: Location

  • 7710 S US HIGHWAY 1

    PORT ST LUCIE, FL 349522320

    Phone: (772) 335-5300

    Fax: (772) 200-2131

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-11-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241114001692IPhysician AssistantFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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 34996)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294728465View full group profile
NameSpecialtyState
-FL
Orthopedic Surgery, Diagnostic Radiology, Hand Surgery, Physical Medicine And RehabilitationFL
Orthopedic SurgeryFL
Physician AssistantFL
Physical Therapist In Private PracticeGA
Physician AssistantFL
-FL
Orthopedic SurgeryFL
Orthopedic SurgeryFL
Orthopedic SurgeryFL

Reviews

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Frequently asked questions

How do payers reference LILIAN DANIELA MAIRENA (PA)?
For LILIAN DANIELA MAIRENA (PA), use NPI 1114748548 as the unique 10-digit identifier.
Is there an active status for LILIAN DANIELA MAIRENA (PA)?
For scheduling context, LILIAN DANIELA MAIRENA (PA) is shown as active in the registry.
How would a patient describe LILIAN DANIELA MAIRENA (PA)'s focus?
For LILIAN DANIELA MAIRENA (PA), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with LILIAN DANIELA MAIRENA (PA)?
Directory geography for LILIAN DANIELA MAIRENA (PA) centers on Stuart, Florida.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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