Individual provider Active NPI

Richard Simpson, PA-C

  • Physician Assistant
  • Davie, FL
National Provider Identifier
1023650793
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111714 Issued in FL
Practice address
4780 SW 64TH Ave Ste 101
Davie, FL 33314-4400
Phone
(954) 434-1705
NPI assigned
Oct 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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 PA9111714 FL Primary

Addresses

Primary practice location

4780 SW 64TH Ave Ste 101
Davie, FL 33314-4400

Mailing address

4780 SW 64TH Ave Ste 103
Davie, FL 33314-4400
Phone (786) 370-1446

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
I20221018003517 FL Practitioner - Physician Assistant 1759757693 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associatesmd Medical Group IncGroup PAC ID 6507294311, 38 clinicians

Practice addresses (Care Compare)

2004 N Famingo Rd
Pembroke Pines, FL 33028-3500
Phone (954) 450-8500

2122 NW 62 St
Suite 110
Ft. Lauderdale, FL 33309-1866
Phone (954) 353-3180

350 N Pine Island Rd
Suite 200
Plantation, FL 33324-1849
Phone (954) 424-4321

4780 Davie Rd
Davie, FL 33314-4400

4780 SW 64TH Ave
Suite 101
Davie, FL 33314-4400
Phone (954) 434-1705

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9111714FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Associatesmd Medical Group Inc CurrentSince Jan 6, 2025 Accepting new patients
Tenet Florida Physician Services II, LLC Physician Assistant CurrentSince Jun 29, 2023 Accepting new patients
South Broward Hospital District CurrentSince Sep 26, 2022 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince Jun 29, 2023 Accepting new patients
South Broward Hospital District CurrentSince Sep 26, 2022 Accepting new patients

Locations

4780 SW 64th Ave
Ste 101
Davie, FL 33314

4780 SW 64th Ave
Ste 103
Davie, FL 33314

4801 S University Dr
Ste 104
Davie, FL 33328

4780 SW 64th Ave
Davie, FL 33314

3000 Bayview Dr
Ft Lauderdale, FL 33306
Phone (954) 393-1708

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

350 N Pine Island Rd
Ste 200
Plantation, FL 33324
Phone (954) 424-4321

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 6

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": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1023650793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 SW 64TH AVE STE 103",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144400",
            "telephone_number": "786-370-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4780 SW 64TH AVE STE 101",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144400",
            "telephone_number": "954-434-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "RICHARD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-14",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.