Andrea Soledad Pagan

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME168842 Issued in FL

Practice address

3635 Clyde Morris Blvd Ste 100
Port Orange, FL 32129-2349

Phone

(386) 788-1242

Fax

(386) 756-8802

NPI assigned

Oct 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

San Juan Bautista School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
• Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• FL PPO
• FL HMO D-SNP
• FL HMO
• FL HMO C-SNP

Interoperability endpoints

• Direct secure messaging: andrea.pagan.p1@direct.bgclinic.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Borland Groover Clinic, PA

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1881644912
  Medicare reassignment Care Compare group NPD

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

• Memorial Health Systems Inc

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation
• Southeast Volusia Healthcare Corporation

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1871977942
  Care Compare affiliation

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1013428549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-398-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 CLYDE MORRIS BLVD STE 100",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292349",
            "telephone_number": "386-788-1242",
            "fax_number": "386-756-8802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Clyde Morris Blvd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321748182",
            "country_code": "US",
            "telephone_number": "386-788-1242",
            "fax_number": "386-756-8802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGAN",
        "first_name": "ANDREA",
        "middle_name": "SOLEDAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME168842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Owen
• Angela M Owens, PT
• Chad Owens, PTA
• Kristi Susann Pace, RBT
• Lisa Packard
• Elyssa Naomi Pagan, DC
• Jared R Pagan, RBT
• Heber Paiva, DMD
• Audrey Paladino
• Dean Anthony Palamara, L.C.S.W.

• Gastroenterology Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.