NPIMap

Individual provider Active NPI

Paul Dominic Lopreato, P.A.

  • Physician Assistant
  • Palm Bay, FL
National Provider Identifier
1447499082
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109473 Issued in FL
Practice address
1051 Port Malabar Blvd NE Ste 6-7
Palm Bay, FL 32905-5153
Phone
(800) 735-1178
Fax
(772) 223-6354
NPI assigned
Feb 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 PA9109473 FL Primary

Addresses

Primary practice location

1051 Port Malabar Blvd NE Ste 6-7
Palm Bay, FL 32905-5153

Mailing address

3699 Alexandria Pike
Alexandria, KY 41076-5121
Phone (859) 442-8444

Other identifiers 2

IdentifierTypeStateIssuer
110227900MedicaidFL
PA9109473OtherFLFLORIDA MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160824001343 FL Practitioner - Physician Assistant 4486645124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dairy Road Urgent Care LLCGroup PAC ID 9133269293, 7 clinicians

Practice addresses (Care Compare)

2107 Dairy Rd
Melbourne, FL 32904-5241
Phone (321) 956-8224

5200 Babcock St NE
Suite 111
Palm Bay, FL 32905-4639
Phone (772) 360-1997

777 37TH St
Suite C101
Vero Beach, FL 32960-7301
Phone (772) 360-1997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Spine and Pain Institute LLC CurrentSince Mar 24, 2025 Accepting new patients
All Partners Network LLC Physician Assistant CurrentSince Apr 28, 2024 Accepting new patients
Interventional Spine and Pain Institute LLC CurrentSince Mar 24, 2025 Accepting new patients
Lakota Medical, LLC Past Accepting new patients
All Partners Network LLC Physician Assistant Past Accepting new patients
Highland Emergency Physicians, Inc. Past Accepting new patients
Cincinnati Centers for Pain Relief Inc Past Accepting new patients
Neuroscience Associates of Northern Kentucky PSC Past Accepting new patients

Locations

4243 NW Federal Hwy
Jensen Beach, FL 34957
Phone 80073511781021

1051 Port Malabar Blvd NE
Ste 67
Palm Bay, FL 32905

777 37th St
Ste C101
Vero Beach, FL 32960
Phone (772) 360-1997

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJDGCD

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1447499082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3699 ALEXANDRIA PIKE",
            "city": "ALEXANDRIA",
            "state": "KY",
            "postal_code": "410765121",
            "telephone_number": "859-442-8444",
            "fax_number": "859-442-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 PORT MALABAR BLVD NE STE 6-7",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329055153",
            "telephone_number": "800-735-1178",
            "fax_number": "772-223-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPREATO",
        "first_name": "PAUL",
        "middle_name": "DOMINIC",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110227900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL BOARD",
            "identifier": "PA9109473",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.