Individual provider Active NPI

Shaina Panchal

  • Physician Assistant
  • Deland, FL
National Provider Identifier
1508434929
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114798 Issued in FL
Practice address
600 W Plymouth Ave
Deland, FL 32720-3260
Phone
(888) 540-9660
Fax
(386) 738-0628
NPI assigned
Jun 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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 PA9114798 FL Primary

Addresses

Primary practice location

600 W Plymouth Ave
Deland, FL 32720-3260

Mailing address

600 W Plymouth Ave
Deland, FL 32720-3260
Phone (888) 540-9660

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
I20220329000762 FL Practitioner - Physician Assistant 2961898051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11021 Spring Hill Dr
Spring Hill, FL 34608-5049
Phone (352) 835-5823

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

14521 University Point PL
Tampa, FL 33613-5424
Phone (813) 977-3600

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

202 Lake Miriam Dr
Suite S1
Lakeland, FL 33813-2188
Phone (863) 647-2333

26344 US Hwy 19 N
Clearwater, FL 33761-4505
Phone (727) 669-3676

27612 Cashford Cir
Suite 102
Wesley Chapel, FL 33544-6954
Phone (813) 991-1457

2835 W de Leon St
Suite 103
Tampa, FL 33609-4130
Phone (813) 287-0443

4132 Woodlands Pkwy
Palm Harbor, FL 34685-3494
Phone (727) 786-5100

540 Medical Oaks Ave
Suite 102
Brandon, FL 33511-5995
Phone (813) 651-1991

6450 38TH Ave N
Suite 420
St Petersburg, FL 33710-1653
Phone (727) 344-6851

6719 Gall Blvd
Suite 106
Zephyrhills, FL 33542-2568
Phone (813) 355-5870

8209 State Rd
Suite 54
New Port Richey, FL 34655-3016
Phone (727) 569-1055

8250 Bryan Dairy Rd
Suite 250
Largo, FL 33777-1360
Phone (727) 393-5300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 1, 2022 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 1, 2022 Accepting new patients
Leavitt Medical Associates of Florida Inc PastSince Apr 30, 2023 Accepting new patients
Leavitt Medical Associates of Florida Inc PastSince Apr 30, 2023 Accepting new patients

Locations

26344 US Highway 19 N
Clearwater, FL 33761
Phone (727) 669-3676

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

8209 State Road 54
New Prt Rchy, FL 34655
Phone (727) 569-1055

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

1720 Dunlawton Ave
Ste 2
Port Orange, FL 32127
Phone (386) 322-8310

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

27612 Cashford Cir
Ste 102
Wesley Chapel, FL 33544
Phone (813) 991-1457

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1623542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1508434929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203260",
            "telephone_number": "888-540-9660",
            "fax_number": "386-738-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203260",
            "telephone_number": "888-540-9660",
            "fax_number": "386-738-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "SHAINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-13",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.