Richard Sanders Gagnon, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9101665 Issued in FL

Practice address

600 Village Square Xing
Palm Beach Gardens, FL 33410-4542

Phone

(561) 694-9493

Fax

(561) 694-9064

NPI assigned

May 31, 2006

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

Electronic endpoints 1

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: rgagnonstu@aquadermatology.emadirect.md

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.

• Aqua Dermatology of Florida, PA

  dba Gardens Plastic Surgery

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1538270335
  Medicare reassignment Care Compare group NPD
• Water's Edge Dermatology, LLC

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1134148992
  Medicare reassignment NPD
• South Florida Orthopaedics & Sports Medicine, PA

  • Orthopaedic Surgery Physician
  • Stuart, FL
  • NPI 1841253374
  NPD (past)
• South Florida Orthopaedics & Sports Medicine,PA

  • Durable Medical Equipment & Medical Supplies
  • Stuart, FL
  • NPI 1639220700
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1275570244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102910",
            "telephone_number": "561-693-0540",
            "fax_number": "561-694-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104542",
            "telephone_number": "561-694-9493",
            "fax_number": "561-694-9064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5101 Okeechobee Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349475415",
            "country_code": "US",
            "telephone_number": "772-595-5995",
            "fax_number": "772-595-5990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "RICHARD",
        "middle_name": "SANDERS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-01-05",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgagnon@directaddress.net",
            "affiliation": "N",
            "address_1": "5101 Okeechobee Rd",
            "city": "Fort Pierce",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349475415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• FWC Urogynecology, LLC
• Gabico Services Inc
• Karema Lashe Gabriel
• Gabriele P Knaus M D PA
• Nikola Gagic, DC
• Christine Gaines
• Neil Igar Galindez, MD
• Karla Yuridia Galindo Mendez, PA-C
• Stephen Thomas Galla, D.M.D.
• Stephanie Lynn Gallander, AP

• Medical Physician Assistant in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.