Individual provider Active NPI

Hissam A Zeidan, PA-C

  • Physician Assistant
  • Viera, FL
National Provider Identifier
1114967700
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3302 Issued in FL
Practice address
2900 Veterans Way
Viera, FL 32940-8007
Phone
(321) 637-3788
NPI assigned
Jun 8, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 PA3302 FL Primary

Addresses

Primary practice location

2900 Veterans Way
Viera, FL 32940-8007

Mailing address

736 Autumn Glen Dr
Melbourne, FL 32940-6421
Phone (321) 637-3788

Other identifiers 1

IdentifierTypeStateIssuer
PA3302OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114967700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 AUTUMN GLEN DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329406421",
            "telephone_number": "321-637-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEIDAN",
        "first_name": "HISSAM",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA3302",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

Verify at the official NPI Registry.