Individual provider Active NPI

Michael Isaac Himes, PA

  • Physician Assistant
  • Vero Beach, FL
National Provider Identifier
1396280681
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAT9110071 Issued in FL
Practice address
960 37TH PL Ste 104
Vero Beach, FL 32960-6586
Phone
(772) 567-8482
NPI assigned
Dec 22, 2016
Last updated
Mar 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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 PAT9110071 FL Primary

Addresses

Primary practice location

960 37TH PL Ste 104
Vero Beach, FL 32960-6586

Mailing address

960 37TH PL Ste 104
Vero Beach, FL 32960-6586
Phone (772) 567-8482

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
I20170324002046 FL Practitioner - Physician Assistant 8921383456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Viva Vero IncGroup PAC ID 4880759604, 2 clinicians

Practice addresses (Care Compare)

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

1700 S 23Rd St
Lawnwood Regional Medical Ce
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

960 37TH PL
Suite 104
Vero Beach, FL 32960-6586
Phone (772) 567-8482

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as group
Quality
99.13
Improvement activities
40
Cost
76.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9110071FLMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1396280681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 37TH PL STE 104",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606586",
            "telephone_number": "772-567-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 37TH PL STE 104",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606586",
            "telephone_number": "772-567-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMES",
        "first_name": "MICHAEL",
        "middle_name": "ISAAC",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-22",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9110071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.