Individual provider Active NPI

Hannah Vakhovsky Gordon

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1457189409
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9119367 Issued in FL
Practice address
1222 S Orange Ave FL 4
Orlando, FL 32806-1215
Phone
(321) 841-6444
NPI assigned
Jul 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA9119367 FL Primary

Addresses

Primary practice location

1222 S Orange Ave FL 4
Orlando, FL 32806-1215

Mailing address

1222 S Orange Ave FL 4
Orlando, FL 32806-1215
Phone (321) 841-6444

Other names 1

  • Hannah Vakhovsky Former name

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
I20241031003540 FL Practitioner - Physician Assistant 8022541804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

22 W Underwood St
Orlando, FL 32806-1110
Phone (407) 648-3800

32 W Gore St
Orlando, FL 32806-1134

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

76 W Underwood St
Orlando, FL 32806-1110

86 W Underwood St
Orlando, FL 32806-1110
Phone (407) 896-1100

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9119367FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1222 S Orange Ave
Fl 4
Orlando, FL 32806
Phone (321) 841-7700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1457189409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE FL 4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-6444",
            "fax_number": "407-650-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE FL 4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "HANNAH",
        "middle_name": "VAKHOVSKY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9119367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "VAKHOVSKY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.