Individual provider Active NPI

Krupali Champaneria, PA

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1104517242
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
885 N Alafaya TRL
Orlando, FL 32828-7049
Phone
(407) 965-5109
NPI assigned
May 18, 2023
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X FL Primary

Addresses

Primary practice location

885 N Alafaya TRL
Orlando, FL 32828-7049

Mailing address

885 N Alafaya TRL
Orlando, FL 32828-7049
Phone (407) 965-5109

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
I20230926002646 FL Practitioner - Physician Assistant 5597119461 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
The Ear Nose and Throat Surgical Associates PAGroup PAC ID 2466437926, 49 clinicians

Practice addresses (Care Compare)

133 Benmore Dr
Suite 100
Winter Park, FL 32792-4111
Phone (407) 644-4883

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9117761FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince Sep 12, 2023 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Sep 12, 2023 Accepting new patients
Kopa LLC CurrentSince Jan 26, 2026 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

2000 N Semoran Blvd
Orlando, FL 32807
Phone (407) 641-5400

5900 Lk Ellenor Dr
Ste 700
Orlando, FL 32809
Phone (407) 216-0101

4660 13th St
Saint Cloud, FL 34769
Phone (321) 805-4650

Organizations & group practices 4

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 2

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": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1104517242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 N ALAFAYA TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287049",
            "telephone_number": "407-965-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 N ALAFAYA TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287049",
            "telephone_number": "407-965-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPANERIA",
        "first_name": "KRUPALI",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.