Individual provider Active NPI

John Jeffrey Deal, PA

  • Physician Assistant
  • Bradenton, FL
National Provider Identifier
1114978657
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103719 Issued in FL
Practice address
206 2ND Street E
Emergency Department
Bradenton, FL 34208
Phone
(941) 745-7564
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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 PA9103719 FL Primary

Addresses

Primary practice location

206 2ND Street E
Emergency Department
Bradenton, FL 34208

Mailing address

403 Mill Run E
Bradenton, FL 34212-9193
Phone (941) 724-0415

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
I20060630000298 FL Practitioner - Physician Assistant 3476565797 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9103719FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Primehealth Urgent Care LLC CurrentSince Jul 27, 2020 Accepting new patients
Primehealth Urgent Care LLC CurrentSince Jul 27, 2020 Accepting new patients
Observation Medical Group LLC CurrentSince Aug 8, 2019 Accepting new patients
Oakfield Drive Emergency Physicians LLC Physician Assistant Past Accepting new patients

Locations

3018 53rd Ave E
Bradenton, FL 34203
Phone (941) 260-2326

8927 US Highway 301 N
#210
Parrish, FL 34219
Phone (941) 845-4621

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1114978657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 MILL RUN E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342129193",
            "telephone_number": "941-724-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 2ND STREET E",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34208",
            "telephone_number": "941-745-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAL",
        "first_name": "JOHN",
        "middle_name": "JEFFREY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.