Individual provider Active NPI

Harold Hidalgo, PA-C

  • Physician Assistant
  • Clearwater, FL
National Provider Identifier
1154562239
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106611 Issued in FL
Practice address
26236 US Highway 19 N
Clearwater, FL 33761-3580
Phone
(727) 953-3599
NPI assigned
Mar 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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 PA9106611 FL Primary

Addresses

Primary practice location

26236 US Highway 19 N
Clearwater, FL 33761-3580

Mailing address

1010 Buttercup GLN
Bradenton, FL 34212-5010
Phone (630) 400-8376

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106611FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MW Wellness Xiii CurrentSince Mar 11, 2025 Accepting new patients
Palumbo Wellness LLC CurrentSince May 7, 2024 Accepting new patients
Gautam Gupta MD LLC Past Accepting new patients

Locations

26236 US Highway 19 N
Clearwater, FL 33761
Phone (727) 953-3599

Organizations & group practices 3

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": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1154562239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 BUTTERCUP GLN",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342125010",
            "telephone_number": "630-400-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26236 US HIGHWAY 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613580",
            "telephone_number": "727-953-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIDALGO",
        "first_name": "HAROLD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-18",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.