Individual provider Active NPI

Debora A. Nash, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1184737280
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103420 Issued in FL
Practice address
14440 Metropolis Avenue
Suite 102
Fort Myers, FL 33912
Phone
(239) 590-8894
Fax
(239) 590-8895
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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 PA9103420 FL Primary

Addresses

Primary practice location

14440 Metropolis Avenue
Suite 102
Fort Myers, FL 33912

Mailing address

7300 Ranch Road 2222, Building 1, Ste 200
Austin, TX 78730
Phone (512) 628-0465

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
I20051021000380 FL Practitioner - Physician Assistant 4284650961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.18 of 100Reported as group
Quality
65.23
Promoting interoperability
100
Improvement activities
40
Cost
75.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6199AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Consultants of Southwest Florida, PL Past Accepting new patients
Southwest Florida Anesthesia, PA Past Accepting new patients
Pain Management Consultants of Southwest Florida, PL PastSince Jun 21, 2014 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1184737280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH ROAD 2222, BUILDING 1, STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78730",
            "telephone_number": "512-628-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 METROPOLIS AVENUE",
            "address_2": "SUITE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-590-8894",
            "fax_number": "239-590-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "DEBORA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.