Individual provider Active NPI

Savannah Ulmer, PAC

  • Surgical Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1477339422
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA117366 Issued in FL
Practice address
2285 N Central Ave Unit 3
Kissimmee, FL 34741-2342
Phone
(689) 215-9360
NPI assigned
Sep 6, 2023
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA117366 FL Primary

Addresses

Primary practice location

2285 N Central Ave Unit 3
Kissimmee, FL 34741-2342

Mailing address

PO Box 370
Fortson, GA 31808-0370
Phone (706) 494-3071

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
I20230929000619 FL Practitioner - Physician Assistant 4082068796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hughston Clinic Southeast PCGroup PAC ID 9234423971, 48 clinicians

Practice addresses (Care Compare)

1401 W Seminole Blvd
Central Florida Regional Hospital
Sanford, FL 32771-6743
Phone (407) 321-4500

2285 N Central Ave
Unit 3
Kissimmee, FL 34741-2342
Phone (689) 215-9360

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA117366FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Clinic Southeast PC CurrentSince Sep 1, 2023 Accepting new patients
Hughston Clinic Southeast PC CurrentSince Sep 1, 2023 Accepting new patients
Hughston Clinic Southeast PC Past Accepting new patients

Locations

2285 N Central Ave
Unit 3
Kissimmee, FL 34741
Phone (407) 595-4983

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

1401 W Seminole Blvd
Fl Regi
Sanford, FL 32771
Phone (407) 302-2620

309 N Mangoustine Ave
Unit G
Sanford, FL 32771
Phone (321) 363-1754

Interoperability endpoints

  • Direct secure messaging: savannah.ulmer.1@321.direct.athenahealth.com

Organizations & group practices 3

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.

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1477339422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "telephone_number": "706-494-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 N CENTRAL AVE UNIT 3",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412342",
            "telephone_number": "689-215-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULMER",
        "first_name": "SAVANNAH",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA117366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.