Active NPI
Crystal R Mead, PA
- Physician Assistant
- Edgewater, FL
National Provider Identifier
1497861306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9102163
- Practice address
- 109 W Knapp Avenue
Edgewater, FL 32132 - Phone
- (386) 427-4544
- Fax
- (386) 427-8688
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9102163 | FL | Primary |
Addresses
Primary practice location
109 W Knapp Avenue
Edgewater, FL 32132
Mailing address
109 W Knapp Avenue
Edgewater, FL 32132
Phone (386) 427-4544
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040429001234 | FL | Practitioner - Physician Assistant | 1759378771 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Endocrinology of Central Florida PA
Practice addresses (Care Compare)
141 Victoria Commons Blvd
Deland, FL 32724-7700
Phone (386) 427-4544
Hospital & facility affiliations
- Adventhealth New Smyrna Beach
- Adventhealth Deland
- Adventhealth Daytona Beach
- Adventhealth Fish Memorial
- Adventhealth Orlando
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Healthcare Partners, Inc | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 2
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Deland, FL
- NPI 1730185307
FL
-
- Internal Medicine Physician
- Daytona Beach, FL
- NPI 1780100529
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
Hospital
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
-
- General Acute Care Hospital
- New Smyrna Beach, FL
- NPI 1871977942
Hospital
-
- General Acute Care Hospital
- Orange City, FL
- NPI 1700978558
Hospital
-
- Internal Medicine Physician
- Orange City, FL
- NPI 1902095078
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1497861306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 W KNAPP AVENUE",
"city": "EDGEWATER",
"state": "FL",
"postal_code": "32132",
"telephone_number": "386-427-4544",
"fax_number": "386-427-8688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 W KNAPP AVENUE",
"city": "EDGEWATER",
"state": "FL",
"postal_code": "32132",
"telephone_number": "386-427-4544",
"fax_number": "386-427-8688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEAD",
"first_name": "CRYSTAL",
"middle_name": "R",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9102163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edgewater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.