Meagan Sumner, PA-C
Individual provider Active NPI Physician Assistant · Malabar, FL
NPI 1043084254 · NPPES record last updated Sep 18, 2024
Key facts
- NPI
- 1043084254
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9118981 (FL)
- Practice address
- 775 Malabar Rd
Malabar, FL 32950-3112 - Phone
- (321) 241-6800
- Fax
- (321) 241-6890
- NPI assigned
- Nov 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 19
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brevard Health Alliance Inc
Practice addresses (Care Compare)
5270 Babcock St NE
Suite 1
Palm Bay, FL 32905-4616
Phone (321) 241-6800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240513001663 | NC | Practitioner - Physician Assistant | 5799126488 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9118981 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Community Health Centers | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9118981 | FL | Yes |
| Primary Care Clinic/Center | 261QP2300X | NC |
Addresses
Primary practice location
775 Malabar Rd
Malabar, FL 32950-3112
Mailing address
PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696
Other practice location 1
40 Autumn Fern Trl
Lillington, NC 27546-5155
Phone (910) 364-0971
Other providers in Malabar, FL
- Amanda R Ross
- Beth Ann Ruede
- Joanne Schneider
- Stephanie Sciortino
- Amanda Rose Sledz
- Jake Tenewitz
- David H Todd
- Ana Elsa Trofibio
- Urgent Care Centers of Brevard County LLC
- David Joseph Weldon Jr.
All providers in Malabar, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.