Individual provider Active NPI

Nicole Leveille, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1346753092
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110898 Issued in FL
Practice address
2415 N Orange Ave Ste 300
Orlando, FL 32804-5505
Phone
(407) 303-2615
Fax
(407) 303-0415
NPI assigned
Nov 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 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 PA9110898 FL Primary

Addresses

Primary practice location

2415 N Orange Ave Ste 300
Orlando, FL 32804-5505

Mailing address

2415 N Orange Ave Ste 300
Orlando, FL 32804-5505
Phone (407) 303-2615

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
I20180523002821 FL Practitioner - Physician Assistant 5597020479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1925 Mizell Ave
Winter Park, FL 32792-4155

2415 N Orange Ave
Orlando, FL 32804-5505

258 S Chickasaw TRL
Orlando, FL 32825-3501

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Apr 16, 2018 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Apr 16, 2018 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2415 N Orange Ave
Ste 300
Orlando, FL 32804
Phone (407) 303-2780

1749 David Walker Dr
Tavares, FL 32778
Phone (352) 742-1760

787 37th St
Ste E170
Vero Beach, FL 32960
Phone (772) 569-3212

1685 Lee Rd
Ste 100
Winter Park, FL 32789
Phone (407) 896-8097

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: nleveille73160@adventhealth.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 2

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": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1346753092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045505",
            "telephone_number": "407-303-2615",
            "fax_number": "407-303-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045505",
            "telephone_number": "407-303-2615",
            "fax_number": "407-303-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVEILLE",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.