Michael A Vandewater, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAT9107313 Issued in FL

Practice address

133 Benmore Dr Ste 100
Winter Park, FL 32792-4111

Phone

(407) 644-4883

Fax

(407) 644-3697

NPI assigned

Jul 9, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guidewell Emergency Medicine Doctors, LLCGroup PAC ID 8224352919, 88 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• 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 and National Provider Directory roles.

• Guidewell Emergency Medicine Doctors, LLC

  • Urgent Care Clinic/Center
  • Winter Park, FL
  • NPI 1629497235
  Medicare reassignment Care Compare group
• Emergency Physicians of Central Florida LLP

  • Emergency Medicine Physician
  • Orlando, FL
  • NPI 1326033341
  Medicare reassignment
• Guidewell Emergency Medicine Doctors, LLC

  • Radiology Clinic/Center
  • Winter Park, FL
  • NPI 1639973555
  NPD (past)
• Heathrow Internal Medicine LLC

  • Family Medicine Physician
  • Lake Mary, FL
  • NPI 1033387865
  NPD (past)

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1407297229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628296",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328628296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-644-4883",
            "fax_number": "407-644-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEWATER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9107313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chidambaram Sunder Valliappan, M.D.
• Valora Medical Management of Florida
• Value Care Alliance Aco PLLC
• Gregory Alan Van Dam, PSY.D.
• Megan Lauren Van Deering
• Vanessa Occupational Therapy Services
• Taylor Vanhoozer
• Vanilla Skye Medical Supply LLC
• Kevin Vankorlaar, LMHC
• Eugenio T Vano Jr., MD

• Physician Assistant in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.