Individual provider Active NPI

Grace Andrade, PA

  • Surgical Physician Assistant
  • Winter Garden, FL
National Provider Identifier
1083498398
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9117921 Issued in FL
Practice address
17000 Porter Rd Ste 205
Winter Garden, FL 34787-8915
Phone
(321) 843-5851
Fax
(321) 841-7727
NPI assigned
Aug 21, 2023
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9117921 FL Primary
Orthopaedic Hand Surgery Physician 207XS0106X PAT9117921 FL

Addresses

Primary practice location

17000 Porter Rd Ste 205
Winter Garden, FL 34787-8915

Mailing address

17000 Porter Rd Ste 205
Winter Garden, FL 34787-8915
Phone (132) 184-1644

Other practice location 1

1018 Pearson Dr
Oviedo, FL 32765-7041
Phone (407) 227-4680

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
I20231030001590 FL Practitioner - Physician Assistant 2961858873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

17000 Porter Rd
Winter Garden, FL 34787-8915

22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

32 W Gore St
Orlando, FL 32806-1134

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

60 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

76 W Underwood St
Orlando, FL 32806-1110

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9117921FLMDOrthopaedic Hand Surgery Physician
PA9117921FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Hand Surgery CurrentSince Oct 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2023 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

17000 Porter Rd
Ste 205
Winter Garden, FL 34787

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1083498398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 PORTER RD STE 205",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878915",
            "telephone_number": "132-184-1644",
            "fax_number": "321-841-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 PORTER RD STE 205",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878915",
            "telephone_number": "321-843-5851",
            "fax_number": "321-841-7727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1018 Pearson Dr",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327657041",
            "country_code": "US",
            "telephone_number": "407-227-4680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "GRACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9117921",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "FL",
            "license": "PAT9117921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.