Individual provider Active NPI

Nicholas V Baroni, PA

  • Physician Assistant
  • Deland, FL
National Provider Identifier
1023345543
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105289 Issued in FL
Practice address
740 W Plymouth Ave
Deland, FL 32720-3282
Phone
(386) 734-9122
NPI assigned
Nov 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 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 PA9105289 FL Primary

Addresses

Primary practice location

740 W Plymouth Ave
Deland, FL 32720-3282

Mailing address

740 W Plymouth Ave
Deland, FL 32720-3282
Phone (386) 734-9122

Other identifiers 1

IdentifierTypeStateIssuer
PA 9105289OtherFLPA 9105289

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
I20100303000829 FL Practitioner - Physician Assistant 6204971138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Neurology, Inc. CurrentSince Apr 30, 2026 Accepting new patients
Orlando Pain Centers of Excellence LLC Past Accepting new patients

Locations

760 S Volusia Ave
Ste 400
Orange City, FL 32763
Phone (386) 774-0220

725 W Granada Blvd
Ste 22
Ormond Beach, FL 32174
Phone (386) 274-0097

Interoperability endpoints

  • Direct secure messaging: nicholas.baroni.1@29635.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25533/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1023345543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203282",
            "telephone_number": "386-734-9122",
            "fax_number": "386-736-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203282",
            "telephone_number": "386-734-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARONI",
        "first_name": "NICHOLAS",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-04",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA 9105289",
            "identifier": "PA 9105289",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.