Individual provider Active NPI

Tammy D Gaines, PA-C

  • Medical Physician Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1619948775
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9111653 Issued in FL
Practice address
9401 SW Discovery Way Ste 201
Port Saint Lucie, FL 34987-2381
Phone
(772) 288-2400
NPI assigned
Jan 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA9111653 FL Primary

Addresses

Primary practice location

9401 SW Discovery Way Ste 201
Port Saint Lucie, FL 34987-2381

Mailing address

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Other practice location 1

4675 Linton Blvd Ste 200
Delray Beach, FL 33445-6615
Phone (561) 331-5050

Other practice location 2

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Other identifiers 2

IdentifierTypeStateIssuer
KU584OtherFLMEDICARE
11544101OtherFLCAQH ID

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
I20190219003430 FL Practitioner - Physician Assistant 2769403799 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 SE Monterey Rd
Stuart, FL 34994-4512

9401 SW Discovery Way
Port Saint Lucie, FL 34987-2381
Phone (772) 288-2400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001692CTMDProfessional Counselor
PA9111653FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Oct 9, 2023 Accepting new patients
Florida Pain and Rehabilitation Associates Inc CurrentSince Jan 15, 2019 Accepting new patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Oct 9, 2023 Accepting new patients
Florida Pain and Rehabilitation Associates Inc CurrentSince Jan 15, 2019 Accepting new patients
South Florida Orthopaedics & Sports Medicine,PA Past Accepting new patients
Advanced Orthopedics New England Past Accepting new patients

Locations

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

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

9401 SW Discovery Way
Ste 201
Port St Lucie, FL 34987

9401 SW Discovery Way
Ste 101
Port St Lucie, FL 34987
Phone (772) 261-6824

1881 SE Tiffany Ave
Ste 202
Port St Lucie, FL 34952

1050 SE Monterey Rd
Ste 204
Stuart, FL 34994
Phone (772) 781-5960

1050 SE Monterey Rd
Ste 400
Stuart, FL 34994

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

Interoperability endpoints

  • Direct secure messaging: tammy.gainespa.p1@direct.southflaortho.nextgenshare.com

Organizations & group practices 7

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 1

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1619948775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 400",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-288-2400",
            "fax_number": "772-419-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW DISCOVERY WAY STE 201",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872381",
            "telephone_number": "772-288-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4675 Linton Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334456615",
            "country_code": "US",
            "telephone_number": "561-331-5050",
            "fax_number": "561-331-3711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 SE Monterey Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944512",
            "country_code": "US",
            "telephone_number": "772-288-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "TAMMY",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9111653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "KU584",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11544101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.