Regina D Pruitt, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9113304 Issued in FL

Practice address

5717 21St Ave W
Bradenton, FL 34209

Phone

(941) 792-8383

Fax

(941) 792-8484

NPI assigned

May 14, 2007

Sex

Female

Sole proprietor

No

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.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043

  FL

  Medicare reassignment Care Compare group
• St Francis Sleep Allergy and Lung Institute LLC

  • Pulmonary Disease Physician
  • Clearwater, FL
  • NPI 1164553897

  FL

  Medicare reassignment
• Ashwin Gowda MD PA

  • Sleep Medicine (Internal Medicine) Physician
  • Austin, TX
  • NPI 1992982532

  TX

  Medicare reassignment
• Health First Privia Medical Group

  • Orthopaedic Surgery Physician
  • Melbourne, FL
  • NPI 1356296651
  Care Compare group
• Health First Privia Medical Group

  • Foot & Ankle Surgery Podiatrist
  • Fort Myers, FL
  • NPI 1568328847
  Care Compare group
• Health First Privia Medical Group

  • Orthopaedic Surgery Physician
  • Palm Bay, FL
  • NPI 1770449159
  Care Compare group
• All Smiles Sleep Solutions LLC

  • Durable Medical Equipment & Medical Supplies
  • Clearwater, FL
  • NPI 1003589060
  NPD (past)

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Health First Privia Medical Group 247 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.79 of 100Reported as apm

Quality

86.5

Promoting interoperability

100

Improvement activities

40

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: regina.pruitt.1@8042.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 17, 2022.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1295940914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 21ST AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34209",
            "telephone_number": "941-792-8383",
            "fax_number": "941-792-8484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 S East Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342392342",
            "country_code": "US",
            "telephone_number": "941-827-0701",
            "fax_number": "941-365-7057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5601 21st Ave W Ste D",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342095642",
            "country_code": "US",
            "telephone_number": "941-792-8383",
            "fax_number": "941-792-8484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "REGINA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.493",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA-493",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9113304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HF MA",
            "identifier": "PA575",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prof/Guidewell Sanitas Med CNT
• Christine Profito, PSY.D.
• Thomas L. Prosser, P.A.
• Carly Provan, CRNA
• Providia Home Care LLC.
• Publix Pharmacy
• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets Inc

• All providers in Bradenton, FL
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.