Michael Andrew Humphrey, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103795 Issued in FL

Practice address

805 E County Road 466
Lady Lake, FL 32159

Phone

(352) 674-9218

Fax

(352) 259-6069

NPI assigned

Sep 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Paramount Urgent Care Inc

  • Urgent Care Clinic/Center
  • Lady Lake, FL
  • NPI 1891956397
  NPD Authorized official
• Dolphin Emergency Physicians LLC

  • Emergency Medicine Physician
  • Ocala, FL
  • NPI 1871542712
  NPD (past)
• Florida Em-I Medical Services PA

  • Emergency Medicine Physician
  • Ocala, FL
  • NPI 1881643740
  NPD (past)
• Orlando Carenow Urgent Care LLC

  • Urgent Care Clinic/Center
  • Winter Springs, FL
  • NPI 1205389905
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1164526737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E COUNTY ROAD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-674-9218",
            "fax_number": "352-259-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E COUNTY ROAD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-674-9218",
            "fax_number": "352-259-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292865500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Grace Houghtaling, DDS
• Tonya Marie Houghton, ND
• Robert Kent Howell, DMD
• Chris A Hoyland, DPM
• Lynn Hubbard, PA-C
• Maen A Hussein, M.D.
• Michelle Huynh, PHARMD
• Jeff Hyde
• Mohamed Ghoniem Ibrahim, PT
• Quinta Idiare, DMD

• All providers in Lady Lake, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.