Shawn McNichol, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9112703 Issued in FL

Practice address

600 E Dixie Ave
Leesburg, FL 34748-5925

Phone

(352) 323-2337

Fax

(352) 392-8217

NPI assigned

Jul 21, 2019

Last updated

Jan 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Premier Medical Associates of Florida Healthcare, PAGroup PAC ID 6800200940, 64 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

47.54 of 100Reported as apm

Quality

38.49

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Premier Medical Associates of Florida Healthcare, PA

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1023612827
  Medicare reassignment Care Compare group
• Florida Clinical Practice Association Inc

  dba UF Health Physicians

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Premier Medical Associates All Florida, LLC

  dba Premier Medical Associates

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1093829442
  Medicare reassignment
• Florida Clinical Practice Association Inc

  dba UF Health Family Medicine Ocala Heath Brook

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

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

{
    "created_epoch": "1563667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1487207213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100183",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100183",
            "telephone_number": "352-392-0140",
            "fax_number": "352-392-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485925",
            "telephone_number": "352-323-2337",
            "fax_number": "352-392-8217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6818 Slaven Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328194724",
            "country_code": "US",
            "telephone_number": "303-999-9611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNICHOL",
        "first_name": "SHAWN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-21",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105590600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kitania McKinnon, IBCLC
• Tiara Alexis McKiver
• Dionne L McKnight, COTA
• Jamaal A McLeod, D.O.
• John Laird McMullen III, MD
• William S McPherson, RT
• MD Cardiac Anesthesia and Critical Care PLLC
• Robert T Meade, M.D.
• Sean Meagher, MD
• Medical Ventures of America (Lake Regional Urgent Care)

• Physician Assistant in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.