Elisa D. Endicott, P.A.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

PA3672 Issued in FL

Practice address

801 N Orange Ave
Suite 520
Orlando, FL 32801-1026

Phone

(407) 992-0660

Fax

(407) 992-7702

NPI assigned

May 18, 2006

Last updated

Feb 17, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-Florida Dermatology Associates P.a.Group PAC ID 1254233786, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Mid-Florida Dermatology Associates P.a.

  dba NOLA Dermatology

  • Dermatology Physician
  • Orlando, FL
  • NPI 1619018561
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1558314963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N ORANGE AVE",
            "address_2": "SUITE 520",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011026",
            "telephone_number": "407-992-0660",
            "fax_number": "407-992-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N ORANGE AVE",
            "address_2": "SUITE 520",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011026",
            "telephone_number": "407-992-0660",
            "fax_number": "407-992-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDICOTT",
        "first_name": "ELISA",
        "middle_name": "D.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3672",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA3672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Encore Health, LLC
• Andres Santiago Endara-Bravo, M.D.
• Endeavor Balance, LLC
• Endeavor Health VC Services LLC
• Alexandre Endiakov, PHARM.D.
• Abigaile Endiryas
• Endless Comfort Care Inc
• Endmetrx LLC (Medplus Rx Pharmacy)
• Endo-Surgical Center of Florida
• Endocrinology & Diabetes Specialist, LLC

• Dermatology Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.

Verify at the official NPI Registry.