ABDUL SAMAD MEMON (PA-C) – Physician Assistant, NPI 1104128305
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ABDUL SAMAD MEMON (PA-C)
6200 SUNSET DR STE 302
SOUTH MIAMI, FL 331434829
Phone: (786) 888-8820
Type: Mailing
14150 SW 136TH ST
MIAMI, FL 331865506
Phone: (786) 204-4600
Type: Location
450 W SR 434 Ste 3010
Longwood, FL 327505196
Phone: (407) 767-8200
Type: Location
9140 SW 153RD AVE
MIAMI, FL 331962853
Phone: (305) 213-4838
Type: Mailing
450 W SR 434 STE 3010
LONGWOOD, FL 327505196
Phone: (407) 767-8200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $156.
Total Amount is formed as General ($156) + Research ($0) + Ownership ($0) = $156.
Last reported payment date: 2024-08-14 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($156).
Total Amount
$156
General + Research + Ownership
Payments
3
Total payment records
General Amount
$156
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $156 |
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: 2010-12-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101216000374 | I | Physician Assistant | FL | 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 33143)
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Reviews
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