Andrew Selig, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9107633 Issued in FL

Practice address

1673 Mason Ave Ste 305
Daytona Beach, FL 32117-5516

Phone

(386) 274-7118

Fax

(386) 274-6173

NPI assigned

Nov 12, 2013

Last updated

Oct 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Halifax Healthcare Systems Inc

  dba HHCSI Halifax Family Health Center

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  NPD (past)

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1336579374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 MASON AVE STE 305",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175516",
            "telephone_number": "386-274-7118",
            "fax_number": "386-274-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 MASON AVE STE 305",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175516",
            "telephone_number": "386-274-7118",
            "fax_number": "386-274-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIG",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-12",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107633",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010037100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Opal Sekler, MD
• Stephanie Michelle Sekunna
• Selah - Forest Lake Manor, LLC (Forest Lake Manor)
• Select Specialty Hospital - Daytona Beach, Inc.
• Erin Selfridge
• Priscilla Selig
• Norman B Seltzer, MD
• Senior Care Source, Inc. (Care Source Staffing)
• Senior Care Source, Inc. (Care Source Staffing)
• Senior Health Care of Volusia

• Medical Physician Assistant in Daytona Beach, FL
• Providers in Daytona Beach, 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 Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.