Individual provider Active NPI

Adrian James Easterling, PA-C

  • Physician Assistant
  • Lady Lake, FL
National Provider Identifier
1275685158
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104065 Issued in FL
Practice address
805 E County Road 466
Lady Lake, FL 32159-5615
Phone
(352) 674-9218
Fax
(352) 259-6069
NPI assigned
Jan 18, 2007
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104065 FL Primary

Addresses

Primary practice location

805 E County Road 466
Lady Lake, FL 32159-5615

Mailing address

805 E County Road 466
Lady Lake, FL 32159-5615
Phone (352) 674-9218

Other identifiers 1

IdentifierTypeStateIssuer
292743800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paramount Urgent Care Inc CurrentSince Mar 25, 2008 Accepting new patients
Inphynet Contracting Services LLC Physician Assistant Past Accepting new patients
Orlando Carenow Urgent Care LLC Past Accepting new patients

Locations

628 Cagan View Rd
Ste 34
Clermont, FL 34714
Phone (352) 242-1988

8640 E County Road 466
Ste A
The Villages, FL 32162
Phone (352) 205-7923

Organizations & group practices 7

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1275685158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E COUNTY ROAD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595615",
            "telephone_number": "352-674-9218",
            "fax_number": "352-259-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E COUNTY ROAD 466",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595615",
            "telephone_number": "352-674-9218",
            "fax_number": "352-259-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLING",
        "first_name": "ADRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292743800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.