Individual provider Active NPI

Jason Daniel Fagan, PA-C

  • Physician Assistant
  • Winter Park, FL
National Provider Identifier
1538418934
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113844 Issued in FL
Practice address
1693 Lee Rd Ste B
Winter Park, FL 32789-2260
Phone
(407) 622-5766
Fax
(407) 622-5767
NPI assigned
Aug 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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 PA9113844 FL Primary

Addresses

Primary practice location

1693 Lee Rd Ste B
Winter Park, FL 32789-2260

Mailing address

1693 Lee Rd Ste B
Winter Park, FL 32789-2260
Phone (407) 622-5766

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
I20210610003425 FL Practitioner - Physician Assistant 7113178997 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 SW Chamber CT
Suite 105
Port St Lucie, FL 34986-3413
Phone (772) 807-9000

1693 Lee Rd
Suite B
Winter Park, FL 32789-2260
Phone (407) 622-5766

5365 W Atlantic Ave
Suite 504
Delray Beach, FL 33484-8194
Phone (561) 241-9300

5948 Turkey Lake Rd
Orlando, FL 32819-4202
Phone (407) 228-8080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.19 of 100Reported as group
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pain and Rehabilitation Associates Inc CurrentSince May 23, 2023 Accepting new patients
Florida Pain and Rehabilitation Associates Inc CurrentSince May 23, 2023 Accepting new patients
Florida Pain and Rehabilitation Institute Inc Past Accepting new patients
Hughston Orthopaedic Southeast PC PastSince Jun 1, 2021 Accepting new patients

Locations

978 International Pkwy
Ste 1440
Lake Mary, FL 32746
Phone (407) 391-3131

451 S Milwee St
Longwood, FL 32750
Phone (407) 622-7246

451 S Milwee St
Ste 1010
Longwood, FL 32750
Phone (321) 424-6950

1530 Citrus Medical Ct
Ocoee, FL 34761
Phone (407) 565-9280

1530 Citrus Medical Ct
Ste 101
Ocoee, FL 34761
Phone (321) 320-8790

5948 Turkey Lake Rd
Orlando, FL 32819
Phone (407) 228-8080

1170 S Semoran Blvd
Ste A
Orlando, FL 32807
Phone (407) 281-9105

1170 S Semoran Blvd
Orlando, FL 32807
Phone (407) 622-7246

150 SW Chamber Ct
Ste 105
Port St Lucie, FL 34986
Phone (772) 807-9000

1693 Lee Rd
Ste B
Winter Park, FL 32789
Phone (407) 622-5766

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jfagan@nationalspine.emadirect.md

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1538418934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1693 LEE RD STE B",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892260",
            "telephone_number": "407-622-5766",
            "fax_number": "407-622-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 LEE RD STE B",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327892260",
            "telephone_number": "407-622-5766",
            "fax_number": "407-622-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "JASON",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-31",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.