Individual provider Active NPI

Daniel Tres Campbell, PA

  • Physician Assistant
  • Deland, FL
National Provider Identifier
1396268058
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
809 Cypress Oak Cir
Deland, FL 32720-2659
Phone
(904) 209-9280
NPI assigned
Jul 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary
Physician Assistant 363A00000X 8959 AZ
Registered Dietitian 133V00000X ND6497 FL
Physician Assistant 363A00000X PA9110829 FL

Addresses

Primary practice location

809 Cypress Oak Cir
Deland, FL 32720-2659

Mailing address

809 Cypress Oak Cir
Deland, FL 32720-2659
Phone (904) 209-9280

Other practice location 1

790 N Milwaukee St Ste 313
Milwaukee, WI 53202-4148
Phone (888) 803-3370

Other practice location 2

400 N Tampa St Fl 15
Tampa, FL 33602-4730
Phone (888) 803-3370

Other practice location 3

333 1st St Ste A
San Francisco, CA 94105-2661
Phone (888) 803-3331

Other practice location 4

415 N Crescent Dr Ste 320
Beverly Hills, CA 90210-6813
Phone (888) 803-3370

Other practice location 5

9700 N 91st St Ste A115
Scottsdale, AZ 85258-5036
Phone (888) 803-3370

Other practice location 6

2820 NE 214th St Ste 801
Aventura, FL 33180-1269
Phone (888) 803-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA, AZ, WI4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20200103001159 FL Practitioner - Physician Assistant 0749614543 Reassigns benefits to 2 organizations
I20240804000011 CA Practitioner - Physician Assistant 0749614543 Reassigns benefits to 1 organization
I20260107002022 AZ Practitioner - Physician Assistant 0749614543 Reassigns benefits to 1 organization
I20260331001966 WI Practitioner - Physician Assistant 0749614543 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

Practice addresses (Care Compare)

333 1St St
Suite a
San Francisco, CA 94105-3060

440 Franklin St
Bloomfield, NJ 07003-4378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ND6497FLMDRegistered Dietitian
8959AZMDPharmacist
60294CAMDOncology Pharmacist

Organizations & group practices 3

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": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1396268058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 CYPRESS OAK CIR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202659",
            "telephone_number": "904-209-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 CYPRESS OAK CIR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202659",
            "telephone_number": "904-209-9280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 N Milwaukee St Ste 313",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532024148",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Tampa St Fl 15",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336024730",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 1st St Ste A",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941052661",
            "country_code": "US",
            "telephone_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 N Crescent Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902106813",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9700 N 91st St Ste A115",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852585036",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 NE 214th St Ste 801",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331801269",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DANIEL",
        "middle_name": "TRES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-24",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8959",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND6497",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.