Taylor Sophia Edwards, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

267 Grant St
Bridgeport, CT 06610-2870

Phone

(203) 384-3566

NPI assigned

Feb 18, 2020

Sex

Female

Sole proprietor

Yes

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 CA

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

Merit-based Incentive Payment System (MIPS)

Final score

95.31 of 100Reported as group

Quality

83.88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Mission Viejo Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Laguna Beach, CA
  • NPI 1134355597
  Medicare reassignment
• Southern California Emergency Medical Group

  • Emergency Medicine Physician
  • San Pedro, CA
  • NPI 1518588433
  Medicare reassignment
• Petrel Emergency Physicians, a Medical Corporation

  • Emergency Medicine Physician
  • Marina del Rey, CA
  • NPI 1154734663
  NPD (past)

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1407489560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 STATE ST APT 7E",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733139",
            "telephone_number": "949-355-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102870",
            "telephone_number": "203-384-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TAYLOR",
        "middle_name": "SOPHIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Neikirk Edgell
• Kristin L. Edgerton
• Edward M Lane MD PC
• Kimberly Edwards, PT
• Nicole Danielle Edwards, D.D.S.
• Edwine Partners LLC (Laudej Group Home)
• Dmitry Egorov, M.D.
• Amina Egorova, M.D.
• Kevin Ehl
• Ej Ventures 2 LLC

• Physician Assistant in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.