Individual provider Active NPI

Krupa Gandhi, PA-C

  • Medical Physician Assistant
  • Daytona Beach, FL
National Provider Identifier
1174245922
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9120025 Issued in FL
Practice address
1350 S Nova Rd
Daytona Beach, FL 32114-5812
Phone
(872) 231-3162
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X PA9120025 FL Primary

Addresses

Primary practice location

1350 S Nova Rd
Daytona Beach, FL 32114-5812

Mailing address

PO Box 7410884
Chicago, IL 60674-0884
Phone (702) 899-0595

Other names 1

  • Krupa Patel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221128002964 PA Practitioner - Physician Assistant 7012385842 Reassigns benefits to 2 organizations
I20250716003897 FL Practitioner - Physician Assistant 7012385842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excellence Health LLCGroup PAC ID 0840534160, 49 clinicians
Grand View HospitalGroup PAC ID 8022001924, 94 clinicians

Practice addresses (Care Compare)

1630 Mason Ave
Suite C
Daytona Beach, FL 32117-4503
Phone (386) 238-9064

3 Life Mark Dr
Sellersville, PA 18960-1598
Phone (215) 257-1127

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grand View Hospital CurrentSince Aug 1, 2024 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Nov 29, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc. CurrentSince Nov 29, 2022 Accepting new patients
Grand View Hospital CurrentSince Aug 1, 2024 Accepting new patients

Locations

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

700 Lawn Ave
Fl 2
Sellersville, PA 18960

3 Life Mark Dr
Sellersville, PA 18960
Phone (215) 257-1127

Interoperability endpoints

  • Direct secure messaging: kpatel353693@direct-sluhn.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1174245922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7410884",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740884",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S NOVA RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145812",
            "telephone_number": "872-231-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "KRUPA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9120025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRUPA",
            "last_name": "PATEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.