Individual Healthcare Provider
Raina Diedrick, PHYSICIAN ASSISTANT
Provider's NPPES record last updated: June 10, 2020
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1073895132
- Primary Specialty
- Physician Assistant
- Practice Location
- Fort Lauderdale, Florida
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 3:08 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Taxonomy code 363A00000X
Provider-Reported License Information
- Physician Assistant (Florida)
- PA9107904
- Physician Assistant (Florida)
- 000000000
Practice Locations
Practice Location
1995 E Oakland Park Blvd
Ste 310
Fort Lauderdale, Florida 33306-1138
Phone: (954) 791-6146
Additional Practice Location
17546 Montessa Ter
Jacksonville, Florida 32226-1122
Phone: (561) 385-4029
Record Information
- Enumeration Date
- September 15, 2011
- Provider's NPPES Record Last Updated
- June 10, 2020
- Certification Date
- June 10, 2020
- NPISignal NPPES Dataset
- August 2026
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