Individual provider Active NPI

Anand Dave, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1184709503
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12413 Issued in GA
Practice address
2 Tampa General Cir
Tampa, FL 33606-3571
Phone
(813) 821-8038
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1078 AR
Physician Assistant 363A00000X 0011335 NY
Physician Assistant 363A00000X PA9109622 FL
Physician Assistant 363A00000X 12413 GA Primary

Addresses

Primary practice location

2 Tampa General Cir
Tampa, FL 33606-3571

Mailing address

2119 Mary LN
Palm Harbor, FL 34685-2110
Phone (516) 459-5092

Other practice location 1

3003 W Dr Martin Luther King Jr Blvd Fl 2
Tampa, FL 33607-6307
Phone (813) 321-6580

Other practice location 2

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 3

5 E 98th St
9th Floor
New York, NY 10029-6501
Phone (212) 241-7261

Other identifiers 2

IdentifierTypeStateIssuer
N2UFPOtherFLBCBS
102421100MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Mail Direct
Direct Messaging Address adave214893@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL, IL, AR, GA5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20110923000235 NJ Practitioner - Physician Assistant 7012011372 Reassigns benefits to 1 organization
I20190226000104 FL Practitioner - Physician Assistant 7012011372 Reassigns benefits to 1 organization
I20211019002049 IL Practitioner - Physician Assistant 7012011372 Reassigns benefits to 1 organization
I20220602000396 AR Practitioner - Physician Assistant 7012011372 Reassigns benefits to 1 organization
I20240812001455 GA Practitioner - Physician Assistant 7012011372 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011335NYMDMental Health Counselor
0011335NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohi West Medical Group, LLC CurrentSince Oct 1, 2020 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Aug 1, 2024 Accepting new patients
Emory Medical Care Foundation CurrentSince Aug 1, 2024 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
University of Arkansas for Medical Science CurrentSince Apr 28, 2022 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 28, 2022 Accepting new patients
Carle Health Care Incorporated CurrentSince Oct 11, 2021 Accepting new patients
University Medical Service Association Inc Physician Assistant Past Accepting new patients

Locations

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: adave189340@orlandohealth.medalliesdirect.net
  • Direct secure messaging: adave214893@direct.tgh.org
  • Direct secure messaging: adavepa337530@carlehiedirect.net

Organizations & group practices 11

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1184709503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 MARY LN",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852110",
            "telephone_number": "516-459-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-821-8038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 W Dr Martin Luther King Jr Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076307",
            "country_code": "US",
            "telephone_number": "813-321-6580",
            "fax_number": "813-443-8185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 W Markham St # 783",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 E 98th St",
            "address_2": "9th Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296501",
            "country_code": "US",
            "telephone_number": "212-241-7261",
            "fax_number": "212-534-6145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVE",
        "first_name": "ANAND",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-1078",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0011335",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109622",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "N2UFP",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102421100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Mail",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3003 W Dr Martin Luther King Jr Blvd Fl 2",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336076307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adave214893@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.