Active NPI
Paul I Avidon, PA
- Surgical Physician Assistant
- Stuart, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA0001609
- Practice address
- 1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512 - Phone
- (772) 288-2400
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA0001609 | FL | |
| Surgical Physician Assistant | 363AS0400X | PA0001609 | FL | Primary |
Addresses
Primary practice location
1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Mailing address
1050 SE Monterey Rd
Suite 400
Stuart, FL 34994-4512
Phone (772) 288-2400
Other practice location 1
9401 SW Discovery Way
Port St Lucie, FL 34987-2376
Phone (772) 288-2400
Other practice location 2
900 Village Square Xing Ste 170
Palm Beach Gardens, FL 33410-4549
Phone (772) 288-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E4181 | Other | MEDICARE SPECIFIED |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1050 SE Monterey Rd
Stuart, FL 34994-4512
Hospital & facility affiliations
- Cleveland Clinic Martin North Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0001609 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Florida Orthopaedics & Sports Medicine, PA | Current | Accepting new patients | |
| South Florida Orthopaedics & Sports Medicine, PA | Current | Accepting new patients | |
| South Florida Orthopaedics & Sports Medicine,PA | Past | Accepting new patients |
Locations
900 Village Square Xing
Ste 170
Palm Beach Gardens, FL 33410
9401 SW Discovery Way
Ste 201
Port St Lucie, FL 34987
9401 SW Discovery Way
Port St Lucie, FL 34987
1050 SE Monterey Rd
Ste 400
Stuart, FL 34994
Interoperability endpoints
- paul.avidonpac.p1@direct.southflaortho.nextgenshare.com
- pavidon19284@jupitermedicalcenter.direct-ci.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.
-
- Orthopaedic Surgery Physician
- Stuart, FL
- NPI 1841253374
-
- Durable Medical Equipment & Medical Supplies
- Port St Lucie, FL
- NPI 1609763440
-
- Durable Medical Equipment & Medical Supplies
- Stuart, FL
- NPI 1639220700
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Stuart, FL
- NPI 1194790055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1265417802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 SE MONTEREY RD",
"address_2": "SUITE 400",
"city": "STUART",
"state": "FL",
"postal_code": "349944512",
"telephone_number": "772-288-2400",
"fax_number": "772-419-0143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 SE MONTEREY RD STE 400",
"city": "STUART",
"state": "FL",
"postal_code": "349944512",
"telephone_number": "772-288-2400"
}
],
"practiceLocations": [
{
"address_1": "9401 SW Discovery Way",
"address_purpose": "LOCATION",
"city": "Port St Lucie",
"state": "FL",
"postal_code": "349872376",
"country_code": "US",
"telephone_number": "772-288-2400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "900 Village Square Xing Ste 170",
"address_purpose": "LOCATION",
"city": "Palm Beach Gardens",
"state": "FL",
"postal_code": "334104549",
"country_code": "US",
"telephone_number": "772-288-2400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AVIDON",
"first_name": "PAUL",
"middle_name": "I",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA0001609",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA0001609",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE SPECIFIED",
"identifier": "E4181",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.