Individual provider Active NPI

Theresa McCready, P.A.

  • Physician Assistant
  • Safety Harbor, FL
National Provider Identifier
1003883943
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9104660 Issued in FL
Practice address
3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone
(727) 507-3600
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 010412-1 NY
Physician Assistant 363A00000X 9104660 FL Primary

Addresses

Primary practice location

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607

Mailing address

10339 Creation CT
New Port Richey, FL 34654-3661
Phone (631) 786-9123

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
I20081203000813 FL Practitioner - Physician Assistant 4183671456 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010412NYMDClinical Psychologist
9104660FLMDPhysician Assistant
010412-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastline Emergency Physicians LLC Physician Assistant CurrentSince Aug 15, 2011 Accepting new patients
Dispatchhealth-Florida Inc. PastSince Aug 1, 2021 Accepting new patients

Locations

601 Main St
Dunedin, FL 34698
Phone (727) 461-1133

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1003883943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10339 CREATION CT",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346543661",
            "telephone_number": "631-786-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 MCMULLEN BOOTH RD",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956607",
            "telephone_number": "727-507-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREADY",
        "first_name": "THERESA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010412-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9104660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.