Gregory Ulysses Chardon Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9107251 Issued in FL

Practice address

1700 SE Hillmoor Dr Ste 500
Port St Lucie, FL 34952-7536

Phone

(772) 335-3200

Fax

(877) 406-5592

NPI assigned

Aug 27, 2013

Last updated

Oct 8, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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 OH

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

91.05 of 100Reported as group

Quality

84.85

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Emergency Professional Services, Inc.

  dba Emergency Professional Services of Ohio, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment
• Knox Emergency Services, LLC

  • Emergency Medicine Physician
  • Mount Vernon, OH
  • NPI 1861450066
  Medicare reassignment
• Mid-Ohio Emergency Group, LLC

  • Emergency Medicine Physician
  • Mansfield, OH
  • NPI 1881164010
  Medicare reassignment
• North Central Ohio Family Care Center, Inc

  • Specialist
  • Galion, OH
  • NPI 1689822827
  Medicare reassignment
• Steward Emergency Physicians Ohio Inc

  • Emergency Medicine Physician
  • Warren, OH
  • NPI 1124501861
  Medicare reassignment

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1467886408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR STE 500",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527536",
            "telephone_number": "772-335-3200",
            "fax_number": "877-406-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SE HILLMOOR DR STE 500",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527536",
            "telephone_number": "772-335-3200",
            "fax_number": "877-406-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARDON",
        "first_name": "GREGORY",
        "middle_name": "ULYSSES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D Champion
• Amanda Chaney, DNP
• Change of Mind LLC
• George Chapelin Fiol
• Karrie L Chapman, PT
• Micayla Charite, RBT
• Robert Charkowick, DO
• Abigail Charles
• Evelyne Charles
• Ifonie Charles

• Physician Assistant in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.