Individual provider Active NPI

Suzanne Marie Gregorio, PAC

  • Physician Assistant
  • Dunedin, FL
National Provider Identifier
1487610127
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115324 Issued in FL
Practice address
870 Patricia Ave
Dunedin, FL 34698-6022
Phone
(872) 231-3162
Fax
(702) 977-1496
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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 PA9115324 FL Primary

Addresses

Primary practice location

870 Patricia Ave
Dunedin, FL 34698-6022

Mailing address

PO Box 7410884
Chicago, IL 60674-0884
Phone (702) 899-0595

Other identifiers 1

IdentifierTypeStateIssuer
126647800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150109002062 OH Practitioner - Physician Assistant 8325362858 Reassigns benefits to 2 organizations
I20231106002771 KY Practitioner - Physician Assistant 8325362858 Reassigns benefits to 1 organization
I20250501001838 FL Practitioner - Physician Assistant 8325362858 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Rehab Consultants PLLC CurrentSince Apr 10, 2024 Accepting new patients
Theoria Medical Physician Assistant CurrentSince May 9, 2023 Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

100 Carmel Manor Dr
Fort Thomas, KY 41075
Phone (859) 781-5111

2344 Amsterdam Rd
Villa Hills, KY 41017
Phone (859) 341-3981

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

5999 Bender Rd
Cincinnati, OH 45233
Phone (513) 922-1440

3627 Harvey Ave
Cincinnati, OH 45229
Phone (513) 961-8881

8151 Norton Pkwy
Mentor, OH 44060
Phone (440) 299-5500

6922 Ohio Ave
Silverton, OH 45236
Phone (513) 793-2090

1030 High St
Worthington, OH 43085
Phone (614) 876-7356

Organizations & group practices 4

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1487610127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7410884",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740884",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 PATRICIA AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346986022",
            "telephone_number": "872-231-3162",
            "fax_number": "702-977-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORIO",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126647800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.