Alyssa Henry Proffitt, PA
Individual provider Active NPI Physician Assistant · Hawthorne, FL
NPI 1003301995 · NPPES record last updated Jun 20, 2023
Key facts
- NPI
- 1003301995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 212 Lake Ray Rd
Hawthorne, FL 32640-5706 - Phone
- (352) 284-1402
- NPI assigned
- Jun 25, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 47.54 of 100
- Quality
- 38.49
- Promoting interoperability
- 0
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181214000626 | FL | Practitioner - Physician Assistant | 7911242235 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Current |
Accepting new patients | |
| Florida Clinical Practice Association Inc | Current |
Accepting new patients |
Locations
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
Interoperability endpoints
- ahenry246002@direct.shands.ufl.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | FL | Yes |
Addresses
Primary practice location
212 Lake Ray Rd
Hawthorne, FL 32640-5706
Mailing address
208 Lake Ray Rd
Hawthorne, FL 32640-5706
Phone (352) 284-1402
Other providers in Hawthorne, FL
- Open Arms Medical Center at
- Gary Richard Parker
- Susan Perko
- Althea Pontoon
- Patricia Ann Powers
- Greta Marie Degen Pursley
- Rely on Homecare LLC
- Crista Marina Ana Lucia Rosborough
- Rural Health Care Incorporated
- Rural Health Care, Incorporated
All providers in Hawthorne, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.