Active NPI
Ky Dau, PA-C
- Physician Assistant
- Lutz, FL
National Provider Identifier
1144778457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9109120
- Practice address
- 5332 Van Dyke Rd
Lutz, FL 33558-4829 - Phone
- (813) 960-1200
- Fax
- (813) 441-7555
- NPI assigned
- Sep 15, 2016
- Reactivated
- May 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9109120 | FL | Primary |
Addresses
Primary practice location
5332 Van Dyke Rd
Lutz, FL 33558-4829
Mailing address
5332 Van Dyke Rd
Lutz, FL 33558-4829
Phone (813) 960-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9109120 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dang Wynn Medical | Past | Accepting new patients |
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.
-
- Medical Physician Assistant
- Lutz, FL
- NPI 1538521596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1144778457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5332 VAN DYKE RD",
"city": "LUTZ",
"state": "FL",
"postal_code": "335584829",
"telephone_number": "813-960-1200",
"fax_number": "813-441-7555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5332 VAN DYKE RD",
"city": "LUTZ",
"state": "FL",
"postal_code": "335584829",
"telephone_number": "813-960-1200",
"fax_number": "813-441-7555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAU",
"first_name": "KY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-15",
"last_updated": "2019-05-08",
"deactivation_date": "2017-11-08",
"reactivation_date": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9109120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.