Individual provider Active NPI

Pascal P Gedeon, PA

  • Medical Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1194872317
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA0002523 Issued in FL
Practice address
2330 S Congress Ave
West Palm Beach, FL 33406-7608
Phone
(561) 432-5849
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA0002523 FL Primary

Addresses

Primary practice location

2330 S Congress Ave
West Palm Beach, FL 33406-7608

Mailing address

800 Imperial Lake Rd
West Palm Beach, FL 33413-1072
Phone (561) 633-9573

Other practice location 1

5867 Okeechobee Blvd
West Palm Beach, FL 33417-4344
Phone (561) 432-5849

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
I20121116000122 FL Practitioner - Physician Assistant 0648421826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Foundcare IncGroup PAC ID 7911043542, 19 clinicians

Practice addresses (Care Compare)

2330 S Congress Ave
Palm Springs, FL 33406-7608
Phone (561) 432-5849

5867 Okeechobee Blvd
West Palm Beach, FL 33417-4344
Phone (561) 432-5849

Hospital & facility affiliations

  • Good Samaritan Medical Center Hospital, West Palm Beach, FL, CCN 100287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0002523FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Foundcare, Inc. CurrentSince Aug 26, 2021 Accepting new patients
Foundcare, Inc. Past Accepting new patients

Locations

5867 Okeechobee Blvd
West Palm Beach, FL 33417
Phone (561) 432-5849

2330 S Congress Ave
West Palm Beach, FL 33406
Phone (561) 432-5849

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 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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1194872317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 IMPERIAL LAKE RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334131072",
            "telephone_number": "561-633-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S CONGRESS AVE",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334067608",
            "telephone_number": "561-432-5849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5867 Okeechobee Blvd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334174344",
            "country_code": "US",
            "telephone_number": "561-432-5849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEDEON",
        "first_name": "PASCAL",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA0002523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.