Dale Shaquille Richardson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PENDING Issued in FL

Practice address

671 S Kings Ave
Brandon, FL 33511-6048

Phone

(813) 972-3750

NPI assigned

Sep 11, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mori Bean and Brooks Inc

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070
  Medicare reassignment Care Compare group
• Imad Al-Nakshabendi M D P a

  • Gastroenterology Physician
  • Brandon, FL
  • NPI 1093995821
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Galencare, Inc.

  • General Acute Care Hospital
  • Brandon, FL
  • NPI 1669427258
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1245017540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 WILLIAMS AVE",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313247215",
            "telephone_number": "912-332-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 S KINGS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116048",
            "telephone_number": "813-972-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DALE",
        "middle_name": "SHAQUILLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard a Assing DDS PA
• Richard E. Rogovin, DC, PA
• Richard J Eatroff M.D, P.a.
• Richard R Landrigan M D L L C
• Debra Richards
• Destini C Richardson
• Navodene A Richardson, M.S.W., RCSWI
• Tyrone Andre Richardson
• Robin Claire Richmond, OTR
• Bernadette Anne Richter, RBT

• Physician Assistant in Brandon, FL
• Providers in Brandon, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.