JACQUELINE MARIE SMALL (PA-C) – Medical Physician Assistant, NPI 1700939410

JACQUELINE MARIE SMALL (PA-C) is a healthcare provider. based in Miami shores, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA9103968 (FL). The NPI Number for JACQUELINE MARIE SMALL (PA-C) is 1700939410

Main info

Female
17 Years Of Experience
Name
JACQUELINE MARIE SMALL (PA-C)
NPI
1700939410
Phone
(786) 443-4313
Address
166 NW 103RD ST
Enumeration Date
18 January 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3059325500
Graduation Year
2009 (17 years ago)
PAC ID
0345521662
Group Practice PAC ID
7911148325
Professional Enrollment ID
I20190107002223
Address ID
FL331801229AV21110BLVD305
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

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Provider Addresses for JACQUELINE MARIE SMALL (PA-C)

  • 166, Northwest 103rd Street, Miami Shores, Miami-Dade County, Florida, 33150, United States

    MIAMI SHORES, FL 331501236

    Phone: (786) 443-4313

    Fax: (305) 762-5848

    Type: Mailing

  • 6015, Northwest 7th Avenue, Miami, Miami-Dade County, Florida, 33127, United States

    MIAMI, FL 331271109

    Phone: (305) 756-5502

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $45.

Total Amount is formed as General ($45) + Research ($0) + Ownership ($0) = $45.

Last reported payment date: 2024-12-24 • Largest payer in this snapshot: Alkermes, Inc. ($45).

Total Amount

$45

General + Research + Ownership

Payments

2

Total payment records

General Amount

$45

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Alkermes, Inc.$45
View all Open Payments →|Open Payments Risk Radar →

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: 2019-01-07

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
I20190107002223IPhysician 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 33150)

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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: 7911148325View full group profile
NameSpecialtyState
Clinical Social WorkerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
P S Y C H I A T R YFL

Reviews

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Frequently asked questions

What is the 10-digit NPI for JACQUELINE MARIE SMALL (PA-C)?
JACQUELINE MARIE SMALL (PA-C) — NPI 1700939410 — is the standard way to identify this listing.
Does CMS list JACQUELINE MARIE SMALL (PA-C) as active?
Yes — JACQUELINE MARIE SMALL (PA-C) is active in the NPI listing used on this page.
What is JACQUELINE MARIE SMALL (PA-C)'s primary classification?
Medical Physician Assistant is the headline specialty for JACQUELINE MARIE SMALL (PA-C) here. Clinical services aligned with this taxonomy classification.
Where should I expect JACQUELINE MARIE SMALL (PA-C) on a map?
Expect Miami Shores, Florida as a primary anchor for JACQUELINE MARIE SMALL (PA-C) unless the record lists multiple sites.
Why does JACQUELINE MARIE SMALL (PA-C) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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