Individual provider Active NPI

William Vascik, PA-C, MPAS, MS, ATC

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1639355373
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106354 Issued in FL
Practice address
3210 Cleveland Ave
#100
Fort Myers, FL 33901-7180
Phone
(239) 936-6778
NPI assigned
Jan 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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 PA9106354 FL Primary

Addresses

Primary practice location

3210 Cleveland Ave
#100
Fort Myers, FL 33901-7180

Mailing address

3210 Cleveland Ave
#100
Fort Myers, FL 33901-7180
Phone (239) 936-6778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150812007994 PA Practitioner - Physician Assistant 7214190289 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106354FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc CurrentSince Jun 22, 2015 Accepting new patients
Upmc Community Medicine, Inc CurrentSince Jun 22, 2015 Accepting new patients

Locations

875 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 347-4622

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1639355373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 CLEVELAND AVE",
            "address_2": "#100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017180",
            "telephone_number": "239-936-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 CLEVELAND AVE",
            "address_2": "#100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017180",
            "telephone_number": "239-936-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASCIK",
        "first_name": "WILLIAM",
        "credential": "PA-C, MPAS, MS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-11",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.