Individual provider Active NPI

Quynh-Dao Tonnu, PA-C

  • Physician Assistant
  • Deland, FL
National Provider Identifier
1407359854
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110724 Issued in FL
Practice address
685 Peachwood Dr
Deland, FL 32720-0804
Phone
(386) 736-3463
NPI assigned
Mar 12, 2018
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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 PA9110724 FL Primary

Addresses

Primary practice location

685 Peachwood Dr
Deland, FL 32720-0804

Mailing address

12109 County Road 103
Oxford, FL 34484-2951
Phone (352) 205-8981

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
I20180629000434 FL Practitioner - Physician Assistant 6608122965 Reassigns benefits to 2 organizations

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
Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

2583 S Volusia Ave
Suite 300
Orange City, FL 32763-9129
Phone (386) 736-3463

545 Health Blvd
Daytona Beach, FL 32114-1493
Phone (386) 239-8500

609 W Highland Blvd
Inverness, FL 34452-4638
Phone (352) 726-9707

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9110724FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Institute, LLC CurrentSince Jun 4, 2018 Accepting new patients
Advanced Urology Institute, LLC CurrentSince Jun 4, 2018 Accepting new patients
Doctor House Call LLC PastSince Jan 1, 2019 Accepting new patients
Advanced Urology Institute LLC Past Accepting new patients

Locations

545 Health Blvd
Daytona Beach, FL 32114
Phone (386) 239-8500

685 Peachwood Dr
Deland, FL 32720
Phone (386) 736-3463

609 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-9707

2583 S Volusia Ave
Ste 300
Orange City, FL 32763
Phone (386) 456-2080

12109 County Road 103
Oxford, FL 34484
Phone (352) 205-8981

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida

Organizations & group practices 5

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 3

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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1407359854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 COUNTY ROAD 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842951",
            "telephone_number": "352-205-8981",
            "fax_number": "352-391-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 PEACHWOOD DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327200804",
            "telephone_number": "386-736-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONNU",
        "first_name": "QUYNH-DAO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.