Gwendolyn Bruch Michaelman, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9104166 Issued in FL

Practice address

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Phone

(813) 870-4000

NPI assigned

Mar 22, 2007

Last updated

Jun 30, 2008By 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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gmichaelman71773@epicdirect.hf.org

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.

• Brevard Physician Associates, PLLC

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1598008955
  Medicare reassignment
• Florida Em-I Medical Services PA

  • Emergency Medicine Physician
  • Largo, FL
  • NPI 1831149848
  NPD (past)
• Russell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Largo, FL
  • NPI 1245289180
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1619094174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 W DR MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE NUMBER 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076383",
            "telephone_number": "813-874-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-870-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELMAN",
        "first_name": "GWENDOLYN",
        "middle_name": "BRUCH",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "Q62542",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292912100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael J. Poff, LCSW, PA
• Michael J. Poff, LCSW, PA
• Michael J. Wiley, M.D., P.a.
• Samantha Gross Michael, DPT
• Zina Sargina Michael, OTR
• Caseem Michaels, CASEEM MICHAELS
• Christopher Charles Michaels, CRNA
• Dana R Michaels, PHARMD
• Michelle Loren Michaels, NP
• Michal Waldman DPM PA (North Tampa Foot Care)

• Medical Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.