Individual provider Active NPI

Douglas Re, P.A.

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1235174830
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103254 Issued in FL
Practice address
6001 Webb Rd
Emergency Department
Tampa, FL 33615-3241
Phone
(813) 888-7060
NPI assigned
Jun 18, 2006
Last updated
May 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 PA9103254 FL Primary

Addresses

Primary practice location

6001 Webb Rd
Emergency Department
Tampa, FL 33615-3241

Mailing address

861 SW 78TH Ave
Suite #100B
Plantation, FL 33324-3229
Phone (954) 693-0000

Other identifiers 1

IdentifierTypeStateIssuer
292115400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050604000047 FL Practitioner - Physician Assistant 6901849579 Reassigns benefits to 11 organizations
I20251002003412 SD Practitioner - Physician Assistant 6901849579 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

130 Pablo St
Lakeland, FL 33803-3818
Phone (863) 284-5941

23749 US Hwy 27
Lake Wales, FL 33859-7802
Phone (863) 687-1472

3525 Lakeland Hills Blvd
Lakeland, FL 33805-1965
Phone (863) 603-6565

4710 S Florida Ave
Lakeland, FL 33813-2165
Phone (863) 284-5000

5101 US Hwy 98 S
Lakeland, FL 33812-4384
Phone (863) 284-1647

930 Marcum Rd
Suite 10
Lakeland, FL 33809-4308
Phone (863) 284-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1627SDMDPhysical Therapist
PA9103254FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys CurrentSince Sep 6, 2025 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince May 13, 2017 Accepting new patients
Leesburg Regional Medical Center Physician Services LLC CurrentSince Sep 28, 2025 Accepting new patients
Huron Regional Medical Center Inc CurrentSince Oct 5, 2025 Accepting new patients
Huron Regional Medical Center Inc CurrentSince Oct 5, 2025 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Nov 27, 2017 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince May 13, 2017 Accepting new patients
Huron Laboratory SVC PC Current Accepting new patients
Treasure Coast Medical Associates CurrentSince Jul 9, 2024 Accepting new patients
Avera St Marys CurrentSince Sep 6, 2025 Accepting new patients
Avera St Marys CurrentSince Sep 6, 2025 Accepting new patients
Adventist Health System /Sunbelt, Inc. Physician Assistant CurrentSince Nov 27, 2017 Accepting new patients
Osprey Emergency Physicians LLC Past Accepting new patients
Amelia Express Care, LLC Past Accepting new patients
Lake City Medical Center Emergency Physicians, LLC Past Accepting new patients
Tarpon Springs Emergency Physicians, LLC Past Accepting new patients
Women's Wellness Center, Prof. L.L.C. Past Accepting new patients
Pasco Emergency Physicians LLC Past Accepting new patients
Sebring Emergency Physicians LLC Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

3405 NW Federal Hwy
Jensen Beach, FL 34957
Phone (772) 692-8082

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

17021 US Highway 441
Mount Dora, FL 32757
Phone (352) 323-5762

305 NE Park St
Okeechobee, FL 34972
Phone (772) 692-8082

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

4660 13th St
Saint Cloud, FL 34769
Phone (321) 805-4650

7195 S George Blvd
Sebring, FL 33875
Phone (863) 451-5854

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

172 4th St SE
Huron, SD 57350
Phone (605) 353-6593

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dre56680@lrhs.direct-ci.com
  • Direct secure messaging: dre745210@direct.shands.ufl.edu
  • FHIR API: https://api.platform.athenahealth.com/3382/brand/1/csg/1/fhir/r4

Organizations & group practices 29

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.

View all 29

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1235174830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 SW 78TH AVE",
            "address_2": "SUITE #100B",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243229",
            "telephone_number": "954-693-0000",
            "fax_number": "954-693-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 WEBB RD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153241",
            "telephone_number": "813-888-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RE",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292115400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.