Michelle Anneliese De Marco, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9110641 Issued in FL

Practice address

1530 Celebration Blvd Ste 101
Celebration, FL 34747-5165

Phone

(407) 566-0404

Fax

(407) 566-0411

NPI assigned

Nov 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Michelle Anneliese Cardenas Former name

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHDBCD/Endpoint/CHDBCD

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.

• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  FL, Physician Assistant

  Medicare reassignment NPD
• Celebration Family Physicians LLC

  • Family Medicine Physician
  • Celebration, FL
  • NPI 1659905073

  FL

  Medicare reassignment
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1104339282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 CELEBRATION BLVD STE 101",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475165",
            "telephone_number": "407-566-0404",
            "fax_number": "407-566-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 CELEBRATION BLVD STE 101",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475165",
            "telephone_number": "407-566-0404",
            "fax_number": "407-566-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MARCO",
        "first_name": "MICHELLE",
        "middle_name": "ANNELIESE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110641",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CARDENAS",
            "middle_name": "ANNELIESE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert C Dabrow, MD
• Jay Dai
• Shannon Dawson, MS, RCMHI (PENDING)
• Stephen Nolan Day Jr., PA-C
• Mikaela Rae De Jesus, PA-C
• Massiel Decamps, PSY.D.
• Elizabeth King Decker, MA, LMFT
• Maria Alessandra Dejorge, APRN
• Dental Anesthesia Services LLC
• Nicole Gilmore Derda, AU.D.

• All providers in Celebration, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.