Individual provider Active NPI

Alyssa Seldes, PA

  • Physician Assistant
  • Port St Lucie, FL
National Provider Identifier
1235793852
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9116212 Issued in FL
Practice address
10050 SW Innovation Way
Port St Lucie, FL 34987-2117
Phone
(772) 344-3811
Fax
(772) 335-2422
NPI assigned
Apr 29, 2019
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 024116 NY
Physician Assistant 363A00000X 9116212 FL Primary

Addresses

Primary practice location

10050 SW Innovation Way
Port St Lucie, FL 34987-2117

Mailing address

5296 Turtle Creek Cir
Vero Beach, FL 32967-7643
Phone (585) 764-3679

Other practice location 1

739 Irving Ave Ste 340
Syracuse, NY 13210-1605
Phone (315) 470-7747

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
I20220803004093 FL Practitioner - Physician Assistant 4385079912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10000 SW Innovation Way
Port Saint Lucie, FL 34987-2111
Phone (772) 345-8100

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 223-5665

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024116NYMDSpeech-Language Pathologist
9116212FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Crouse Medical Practice PLLC Past Accepting new patients

Locations

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aseldes2496332@direct.ccf.org

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 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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1235793852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5296 TURTLE CREEK CIR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329677643",
            "telephone_number": "585-764-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 SW INNOVATION WAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872117",
            "telephone_number": "772-344-3811",
            "fax_number": "772-335-2422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "739 Irving Ave Ste 340",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101605",
            "country_code": "US",
            "telephone_number": "315-470-7747",
            "fax_number": "315-470-7758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELDES",
        "first_name": "ALYSSA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024116",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9116212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.