Individual provider Active NPI

Alexander John Byram, PA-C

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1194504662
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9117813 Issued in FL
Practice address
265 E Rollins St Ste 12000
Orlando, FL 32804-5571
Phone
(407) 975-0200
NPI assigned
Sep 25, 2023
Last updated
Sep 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9117813 FL Primary

Addresses

Primary practice location

265 E Rollins St Ste 12000
Orlando, FL 32804-5571

Mailing address

2500 Newbolt Dr
Orlando, FL 32817-2624

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
I20231006002578 FL Practitioner - Physician Assistant 0941655211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairbanks Partners LLCGroup PAC ID 8820303621, 37 clinicians

Practice addresses (Care Compare)

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 975-0200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Partners LLC CurrentSince Sep 27, 2023 Accepting new patients
Orlando Neurosurgery, P.a. Past Accepting new patients

Locations

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

265 E Rollins St
Ste 12000
Orlando, FL 32804

1605 W Fairbanks Ave
Winter Park, FL 32789
Phone (407) 845-8356

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1194504662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NEWBOLT DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328172624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST STE 12000",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045571",
            "telephone_number": "407-975-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRAM",
        "first_name": "ALEXANDER",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9117813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.