Individual provider Active NPI

Pamela Schnell Gilley, PA

  • Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1417107236
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104778 Issued in FL
Practice address
700 W Oak St
Kissimmee, FL 34741-4924
Phone
(407) 518-3800
NPI assigned
Sep 29, 2008
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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 PA9104778 FL Primary

Addresses

Primary practice location

700 W Oak St
Kissimmee, FL 34741-4924

Mailing address

18167 US Highway 19 N
Suite 650
Clearwater, FL 33764-3528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NH, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20090220000379 FL Practitioner - Physician Assistant 1456416759 Reassigns benefits to 2 organizations
I20190531001001 NH Practitioner - Physician Assistant 1456416759 Reassigns benefits to 1 organization
I20191113003518 VA Practitioner - Physician Assistant 1456416759 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9104778FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
FL - I Medical Services LLC Physician Assistant CurrentSince Oct 1, 2016 Accepting new patients
Osprey Emergency Physicians LLC Past Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

18167 US Highway 19 N
Ste 650
Clearwater, FL 33764
Phone (727) 507-2519

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1417107236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18167 US HIGHWAY 19 N",
            "address_2": "SUITE 650",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337643528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414924",
            "telephone_number": "407-518-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEY",
        "first_name": "PAMELA",
        "middle_name": "SCHNELL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.