Individual provider Active NPI

Erin N Allendorfer, PA-C

  • Medical Physician Assistant
  • Bradenton, FL
National Provider Identifier
1043652134
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
206 2ND St E
Bradenton, FL 34208-1042
Phone
(941) 746-5111
Fax
(941) 745-7233
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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 PA9110723 FL
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

206 2ND St E
Bradenton, FL 34208-1042

Mailing address

367 S. Gulph Rd
Att Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (610) 382-4943

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
I20171103001762 FL Practitioner - Physician Assistant 1658515283 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manatee Specialty Physician Alliance LLCGroup PAC ID 8921473927, 27 clinicians
Greater Tampa Bay Physician Specialists LLCGroup PAC ID 2961637715, 33 clinicians

Practice addresses (Care Compare)

200 3Rd Ave W
Suite 110
Bradenton, FL 34205-8628
Phone (941) 746-3115

602 S Audubon Ave
Suite a
Tampa, FL 33609-4217
Phone (813) 877-1415

6450 38TH Ave N
Suite 310
Saint Petersburg, FL 33710-1649
Phone (727) 551-2033

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202-5174
Phone (941) 782-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9110723FLMDPhysician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: erin.allendorfer@hca4.eclinicaldirectplus.com

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": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1043652134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "610-382-4943",
            "fax_number": "610-878-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 2ND ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081042",
            "telephone_number": "941-746-5111",
            "fax_number": "941-745-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLENDORFER",
        "first_name": "ERIN",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110723",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.