Individual provider Active NPI

Taylor Marie Willbur, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1548854854
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9114038 Issued in FL
Practice address
2501 N Orange Ave Ste 235
Orlando, FL 32804-4659
Phone
(321) 732-7774
Fax
(321) 732-7773
NPI assigned
Feb 26, 2021
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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 PA9114038 FL Primary

Addresses

Primary practice location

2501 N Orange Ave Ste 235
Orlando, FL 32804-4659

Mailing address

1358 Cor Jesu CT
Longwood, FL 32750-3304
Phone (407) 767-5548

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
I20210401000212 FL Practitioner - Physician Assistant 1850708264 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2200 Fowler Grove Blvd
Winter Garden, FL 34787-5597

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.03 of 100Reported as group
Quality
77.92
Promoting interoperability
99
Improvement activities
40
Cost
79.67

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince Sep 8, 2022 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince May 1, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince May 1, 2021 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Sep 8, 2022 Accepting new patients
Rothman Orthopaedics of Florida,PLLC CurrentSince Apr 12, 2021 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

2600 Westhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 200-1353

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 235
Orlando, FL 32804
Phone (407) 303-1967

255 N Lakemont Ave
Ste 207
Winter Park, FL 32792
Phone (407) 852-5333

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1548854854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 COR JESU CT",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503304",
            "telephone_number": "407-767-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 235",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044659",
            "telephone_number": "321-732-7774",
            "fax_number": "321-732-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLBUR",
        "first_name": "TAYLOR",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.