Individual provider Active NPI

Joan Eve Swain, PA

  • Physician Assistant
  • Winter Park, FL
National Provider Identifier
1255450250
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9110284 Issued in FL
Practice address
807 S Orlando Ave Ste C
Winter Park, FL 32789-4870
Phone
(407) 894-4693
Fax
(407) 261-3869
NPI assigned
Mar 29, 2007
Last updated
Jun 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 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 9110284 FL Primary
Physician Assistant 363A00000X 5601003492 MI

Addresses

Primary practice location

807 S Orlando Ave Ste C
Winter Park, FL 32789-4870

Mailing address

807 S Orlando Ave Ste C
Winter Park, FL 32789-4870
Phone (407) 894-4693

Other practice location 1

18302 Middlebelt Rd
Livonia, MI 48152-5007
Phone (248) 478-1500

Other identifiers 1

IdentifierTypeStateIssuer
5601003492OtherMIPHYSICIANS ASSISTANT

Other names 1

  • Joan Eve Malcoun Former name

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
I20180306000746 FL Practitioner - Physician Assistant 3779681366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Central Florida, P.a.Group PAC ID 2567359375, 34 clinicians

Practice addresses (Care Compare)

2501 N Orange Ave
Suite 537N
Orlando, FL 32804-4674
Phone (407) 894-4693

4100 Metric Dr
Suite 200
Winter Park, FL 32792-6832
Phone (407) 681-8720

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9110284FLMDPhysician Assistant
5601003492MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Access of Central Florida LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1255450250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S ORLANDO AVE STE C",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894870",
            "telephone_number": "407-894-4693",
            "fax_number": "407-261-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S ORLANDO AVE STE C",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894870",
            "telephone_number": "407-894-4693",
            "fax_number": "407-261-3869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18302 Middlebelt Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481525007",
            "country_code": "US",
            "telephone_number": "248-478-1500",
            "fax_number": "248-478-2798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "JOAN",
        "middle_name": "EVE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9110284",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS ASSISTANT",
            "identifier": "5601003492",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "MALCOUN",
            "middle_name": "EVE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.