Individual provider Active NPI

Ashley R Vrecenak, P.A.

  • Medical Physician Assistant
  • Longwood, FL
National Provider Identifier
1639496565
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105430 Issued in FL
Practice address
515 W State Road 434
Suite 210
Longwood, FL 32750-4981
Phone
(407) 332-8080
Fax
(407) 260-0602
NPI assigned
May 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105430 FL Primary

Addresses

Primary practice location

515 W State Road 434
Suite 210
Longwood, FL 32750-4981

Mailing address

515 W State Road 434
Suite 210
Longwood, FL 32750-4981
Phone (407) 332-8080

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
I20100825001095 FL Practitioner - Physician Assistant 1658495726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group PAGroup PAC ID 4385676782, 11 clinicians

Practice addresses (Care Compare)

2850 Morningside Dr
Mount Dora, FL 32757-6610
Phone (352) 383-0733

515 W Sr
434 Suite 210
Longwood, FL 32750-5162
Phone (407) 332-8080

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105430FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jewett Orthopaedic Clinic LLC Past Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1639496565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W STATE ROAD 434",
            "address_2": "SUITE 210",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504981",
            "telephone_number": "407-332-8080",
            "fax_number": "407-260-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W STATE ROAD 434",
            "address_2": "SUITE 210",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504981",
            "telephone_number": "407-332-8080",
            "fax_number": "407-260-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VRECENAK",
        "first_name": "ASHLEY",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.