David Demetree, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9119416 Issued in FL

Practice address

1055 Saxon Blvd
Orange City, FL 32763-8468

Phone

(386) 917-5000

NPI assigned

Oct 15, 2024

Sex

Male

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Emergency Medicine Professionals PA

  • Emergency Medicine Physician
  • Deland, FL
  • NPI 1205880853
  Medicare reassignment

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1053131995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DEER POND RD",
            "city": "OSTEEN",
            "state": "FL",
            "postal_code": "327649847",
            "telephone_number": "321-295-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 SAXON BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638468",
            "telephone_number": "386-917-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETREE",
        "first_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9119416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delmar Glen Pack PA
• Deltona Medical Arts Pharmacy Inc
• Deltona Medical Center LLC
• Deltona Medical Center LLC
• Deltona Wellness & Psychiatry Clinic PLLC
• Denis J Gulliver Dcpa
• Denoff Orthopaedics, P.a.
• Laith Derbas, MD
• Elizabeth Michelle Derminer, CNM/WHNP
• Rohan K Desai, M.D.

• Physician Assistant in Orange City, FL
• Providers in Orange City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.