Kandace F Vagovic, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2619 Issued in FL

Practice address

517 Health Blvd
Daytona Beach, FL 32114-1493

Phone

(386) 274-1005

Fax

(386) 274-5779

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  Medicare reassignment NPD
• Sterthaus ER SVCS Partnership LLC

  • Emergency Medicine Physician
  • Daytona Beach, FL
  • NPI 1043269376
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1336193044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 HEALTH BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141493",
            "telephone_number": "386-274-1005",
            "fax_number": "386-274-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 HEALTH BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141493",
            "telephone_number": "386-274-1005",
            "fax_number": "386-274-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAGOVIC",
        "first_name": "KANDACE",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292636900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeni Allissun Upton, LMHC
• Paula Andrea Uribe Mejia, CCC SLP
• Usv Optical Inc.
• VA Medical Center
• Isabela Vaccaro, DDS
• Richard J Vagovic, MD
• Margaly Valcourt, ARNP
• Nichole Marie Valdez
• Vanessa Angelique Valdivia, DO
• Howard Valentine, CRNA

• Physician Assistant in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.