Individual provider Active NPI

Daphne Chiu, PA-C

  • Physician Assistant
  • Bradenton, FL
National Provider Identifier
1104562495
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9115874 Issued in FL
Practice address
2902 59TH St W Ste D
Bradenton, FL 34209-7021
Phone
(941) 877-7007
NPI assigned
May 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 9115874 FL Primary

Addresses

Primary practice location

2902 59TH St W Ste D
Bradenton, FL 34209-7021

Mailing address

2902 59TH St W Ste D
Bradenton, FL 34209-7021
Phone (941) 877-7007

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
I20240604003991 FL Practitioner - Physician Assistant 6800338914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palma Sola Neurology AssociatesGroup PAC ID 8527328947, 4 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2902 59TH Steet W
Suite D
Bradenton, FL 34209-7021
Phone (941) 877-7007

7374 San Casa Dr
Englewood, FL 34224-8842
Phone (941) 417-5064

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9115874FLMDPhysician Assistant

Interoperability endpoints

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

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1104562495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 59TH ST W STE D",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097021",
            "telephone_number": "941-877-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 59TH ST W STE D",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097021",
            "telephone_number": "941-877-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "DAPHNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-09",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9115874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.