Individual provider Active NPI

Alexis Auen Gates, PA

  • Physician Assistant
  • Fort Walton Beach, FL
National Provider Identifier
1003687641
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6639
Phone
(850) 863-2153
Fax
(850) 809-4312
NPI assigned
Jan 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6639

Mailing address

1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6639
Phone (850) 863-2153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306003834 FL Practitioner - Physician Assistant 0840636346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

103 Memorial Medical Pkwy
Suite 125
Daytona Beach, FL 32117-5121
Phone (386) 274-0250

Hospital & facility affiliations

  • HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
  • HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054
  • Gulf Breeze Hospital Hospital, Gulf Breeze, FL, CCN 100266
  • North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates, PA CurrentSince Feb 1, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince May 15, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince May 15, 2024 Accepting new patients

Locations

5300 S Ferdon Blvd
Crestview, FL 32536
Phone (850) 344-1646

103 Memorial Medical Pkwy
Ste 125
Daytona Beach, FL 32117
Phone (386) 274-0250

36474C Emerald Coast Pkwy
Ste 3101
Destin, FL 32541
Phone (850) 344-1646

1034 Mar Walt Dr
Unit 100
Ft Walton Bch, FL 32547
Phone (850) 315-9210

1034 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 344-1646

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

554 Twin Cities Blvd
Ste D
Niceville, FL 32578
Phone (850) 315-9210

1827 Harrison Ave
Panama City, FL 32405
Phone (850) 785-4344

Interoperability endpoints

  • Direct secure messaging: alexis.gates.1@9109.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1003687641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476639",
            "telephone_number": "850-863-2153",
            "fax_number": "850-809-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476639",
            "telephone_number": "850-863-2153",
            "fax_number": "850-809-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "ALEXIS",
        "middle_name": "AUEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.