Individual provider Active NPI

Myra Segarra, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1154751683
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9107528 Issued in FL
Practice address
1222 S Orange Ave
Orlando, FL 32806-1215
Phone
(407) 351-5384
Fax
(407) 445-0321
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9107528 FL Primary

Addresses

Primary practice location

1222 S Orange Ave
Orlando, FL 32806-1215

Mailing address

1222 S Orange Ave
Orlando, FL 32806-1215
Phone (407) 351-5384

Other identifiers 2

IdentifierTypeStateIssuer
PA9107528OtherFLMEDICAL LICENSE
010216100MedicaidFL

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
I20131126001170 FL Practitioner - Physician Assistant 7214163054 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Nov 1, 2013 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Network Inc Past Accepting new patients

Locations

1920 Don Wickham Dr
Clermont, FL 34711
Phone (352) 243-5891

587 E State Road 434
Longwood, FL 32750
Phone (407) 896-1100

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

9430 Turkey Lake Rd
Ste 108
Orlando, FL 32819
Phone (407) 237-6377

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1222 S Orange Ave
Orlando, FL 32806
Phone (407) 649-6907

Interoperability endpoints

  • Direct secure messaging: msegarra27769@orlandohealth.medalliesdirect.net

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": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1154751683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "407-351-5384",
            "fax_number": "407-445-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "407-351-5384",
            "fax_number": "407-445-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGARRA",
        "first_name": "MYRA",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9107528",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010216100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.