Individual provider Active NPI

Cassandra Tang

  • Physician Assistant
  • Fort Walton Beach, FL
National Provider Identifier
1225424591
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109501 Issued in FL
Practice address
1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6639
Phone
(850) 863-2153
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 PA9109501 FL Primary

Addresses

Primary practice location

1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6639

Mailing address

1034 Mar Walt Dr
Fort Walton Beach, FL 32547-6639
Phone (850) 863-2153

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
I20180711000868 FL Practitioner - Physician Assistant 0547516221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

11945 San Jose Blvd
Jacksonville, FL 32223-1627
Phone (904) 396-1725

36474 C Emerald Coast Pkwy
Suite 3101
Destin, FL 32541-6701
Phone (850) 344-1646

5300 S Ferdon Blvd
Crestview, FL 32536-5235
Phone (850) 344-1646

554 Twin Cities Blvd
Suite D
Niceville, FL 32578-1058
Phone (850) 344-1646

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA5355MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince May 15, 2024 Accepting new patients
Orthopaedic Associates, PA CurrentSince Jun 6, 2018 Accepting new patients
North Florida Surgeons, PA CurrentSince May 15, 2024 Accepting new patients

Locations

5300 S Ferdon Blvd
Crestview, FL 32536
Phone (850) 344-1646

36474C Emerald Coast Pkwy
Ste 3101
Destin, FL 32541
Phone (850) 344-1646

1034 Mar Walt Dr
Unit 100
Ft Walton Bch, FL 32547
Phone (850) 315-9210

1034 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 344-1646

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

554 Twin Cities Blvd
Ste D
Niceville, FL 32578
Phone (850) 315-9210

1827 Harrison Ave
Panama City, FL 32405
Phone (850) 785-4344

Interoperability endpoints

  • Direct secure messaging: cassandra.tang.1@9109.direct.athenahealth.com

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 3

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1225424591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476639",
            "telephone_number": "850-863-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476639",
            "telephone_number": "850-863-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "CASSANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.