Individual provider Active NPI

Stephen Seitz, PA

  • Physician Assistant
  • Gainesville, FL
National Provider Identifier
1154890879
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111693 Issued in FL
Practice address
224 SE 24TH St
Gainesville, FL 32641-7516
Phone
(352) 334-7900
NPI assigned
Nov 26, 2018
Last updated
Dec 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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 PA9111693 FL Primary

Addresses

Primary practice location

224 SE 24TH St
Gainesville, FL 32641-7516

Mailing address

3510 SW 30TH Way Apt 154
Gainesville, FL 32608-2774

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
I20190115002842 FL Practitioner - Physician Assistant 4688910433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Department of HealthGroup PAC ID 3072424282, 126 clinicians

Practice addresses (Care Compare)

224 SE 24TH St
Gainesville, FL 32641-7516
Phone (352) 334-7900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9111693FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Dec 9, 2018 Accepting new patients
Florida Department of Health CurrentSince Dec 9, 2018 Accepting new patients
Florida Clinical Practice Association Inc Past Accepting new patients
Florida Department of Health Past Accepting new patients

Locations

15530 NW US Highway 441
Ste 10010
Alachua, FL 32615
Phone (352) 462-2542

224 SE 24th St
Gainesville, FL 32641
Phone (352) 334-7900

816 SW 64th Ter
Gainesville, FL 32607
Phone (352) 225-4320

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1154890879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 SW 30TH WAY APT 154",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326082774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SE 24TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326417516",
            "telephone_number": "352-334-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEITZ",
        "first_name": "STEPHEN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.