Individual provider Active NPI

William A Tison III, PA - C

  • Physician Assistant
  • West Palm Beach, FL
National Provider Identifier
1306329693
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111468 Issued in FL
Practice address
901 45TH St
Kimmel Building
West Palm Beach, FL 33407
Phone
(561) 844-5255
Fax
(561) 844-5245
NPI assigned
Sep 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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 PA9111468 FL Primary

Addresses

Primary practice location

901 45TH St
Kimmel Building
West Palm Beach, FL 33407

Mailing address

2055 Military Trail Suite 204
Jupiter, FL 33458
Phone (561) 744-9733

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
I20190123003466 FL Practitioner - Physician Assistant 8325385768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tenet Florida Physician Services II, LLCGroup PAC ID 1456507698, 99 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Fort Lauderdale, FL 33334-4149
Phone (954) 229-8608

600 Heritage Dr
Suite 105
Jupiter, FL 33458-3098
Phone (561) 884-5255

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300

Hospital & facility affiliations

  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

Merit-based Incentive Payment System (MIPS)

Final score
81.65 of 100Reported as group
Quality
66.27
Promoting interoperability
100
Improvement activities
40
Cost
72.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9111468FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services II, LLC CurrentSince Mar 3, 2022 Accepting new patients
Tenet Florida Physician Services II, LLC Physician Assistant CurrentSince Mar 3, 2022 Accepting new patients

Locations

3000 Bayview Dr
#100
Fort Lauderdale, FL 33306
Phone (954) 567-1332

3000 Bayview Dr
Ste 100
Ft Lauderdale, FL 33306
Phone (954) 567-1332

600 Heritage Dr
Ste 105
Jupiter, FL 33458
Phone (561) 935-9233

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

5325 Greenwood Ave
Ste 203
West Palm Beach, FL 33407
Phone (561) 736-7313

5325 Greenwood Ave
Ste 101
West Palm Beach, FL 33407
Phone (561) 830-6093

Interoperability endpoints

  • Direct secure messaging: william.tison.1@13023.direct.athenahealth.com
  • Direct secure messaging: wtison21000@jupitermedicalcenter.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1306329693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 MILITARY TRAIL SUITE 204",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-744-9733",
            "fax_number": "561-331-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH ST",
            "address_2": "KIMMEL BUILDING",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-844-5255",
            "fax_number": "561-844-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISON",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "PA - C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-12",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.