Individual provider Active NPI

Elena Tadioto, PA

  • Physician Assistant
  • Apopka, FL
National Provider Identifier
1366910044
Registry record updated Nov 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111779 Issued in FL
Practice address
1426 Foxden Rd
Apopka, FL 32712-3004
Phone
(321) 277-4004
NPI assigned
Nov 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2018

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 PA9111779 FL Primary

Addresses

Primary practice location

1426 Foxden Rd
Apopka, FL 32712-3004

Mailing address

1426 Foxden Rd
Apopka, FL 32712-3004
Phone (321) 277-4004

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
I20190325002367 FL Practitioner - Physician Assistant 1951641182 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
Mid-Florida Dermatology Associates P.a.Group PAC ID 1254233786, 48 clinicians

Practice addresses (Care Compare)

100 W Gore St
Suite 602
Orlando, FL 32806-1051
Phone (407) 299-7333

1189 Blackwood Ave
Ocoee, FL 34761-4518
Phone (407) 299-7333

200 N Park Ave
Suite a
Apopka, FL 32703-4148
Phone (407) 299-7333

2650 W State Rd
Suite 434
Longwood, FL 32779-4815
Phone (407) 299-7333

6909 Old Hwy 441 S
Suite 111
Mount Dora, FL 32757-7039
Phone (407) 299-7333

7652 Ashley Park CT
Orlando, FL 32835-6199
Phone (407) 299-7333

815 Oakley Seaver Dr
Clermont, FL 34711-1968
Phone (407) 299-7333

844 N Stone St
Suite 204
Deland, FL 32720-3208
Phone (407) 299-7333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9111779FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Florida Dermatology Associates P.a. CurrentSince Feb 25, 2019 Accepting new patients

Locations

200 N Park Ave
Ste A
Apopka, FL 32703

6909 Old Highway 441 S
Ste 111
Mount Dora, FL 32757

100 W Gore St
Ste 602
Orlando, FL 32806
Phone (407) 839-3999

7652 Ashley Park Ct
Ste 305
Orlando, FL 32835
Phone (407) 839-0127

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541894400000",
    "number": "1366910044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 FOXDEN RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327123004",
            "telephone_number": "321-277-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 FOXDEN RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327123004",
            "telephone_number": "321-277-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADIOTO",
        "first_name": "ELENA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-11",
        "last_updated": "2018-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.