Individual provider Active NPI

Maday Campo-Hernandez, PA-C

  • Medical Physician Assistant
  • Altamonte Springs, FL
National Provider Identifier
1205566833
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9116203 Issued in FL
Practice address
1090 W State Road 436
Altamonte Springs, FL 32714-2921
Phone
(407) 869-1030
Fax
(407) 869-1025
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 PA9116203 FL Primary

Addresses

Primary practice location

1090 W State Road 436
Altamonte Springs, FL 32714-2921

Mailing address

1255 Ustler Rd
Apopka, FL 32712-2823
Phone (407) 766-5099

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
I20230420003123 FL Practitioner - Physician Assistant 6507221876 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
Dispatchhealth-Florida Inc.Group PAC ID 2668899220, 36 clinicians

Practice addresses (Care Compare)

650 Northlake Blvd
Suite 400
Altamonte Springs, FL 32701-6126
Phone (407) 743-5360

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9116203FLMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: maday.campo-hernandez.1@13869.direct.athenahealth.com

Organizations & group practices 2

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1205566833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 USTLER RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327122823",
            "telephone_number": "407-766-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W STATE ROAD 436",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142921",
            "telephone_number": "407-869-1030",
            "fax_number": "407-869-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPO-HERNANDEZ",
        "first_name": "MADAY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9116203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.