Dale Phillip Greyslak, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9104508 Issued in FL

Practice address

3491 Titanic Cir
Indialantic, FL 32903-1871

Phone

(407) 451-0192

NPI assigned

May 8, 2008

Last updated

Feb 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
• Orlando Health Melbourne Hospital Hospital, Melbourne, FL, CCN 100291
• Viera Hospital Hospital, Melbourne, FL, CCN 100315

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Dale P Greyslak PA PLLC

  • Surgical Physician Assistant
  • Indialantic, FL
  • NPI 1174945521
  Medicare reassignment Authorized official
• Advanced Surgical & Physician Assistant Services Inc

  • Surgical Physician Assistant
  • Indialantic, FL
  • NPI 1053043059
  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cape Canaveral Hospital, Inc.

  • General Acute Care Hospital
  • Cocoa Beach, FL
  • NPI 1184691610
  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  dba First Flight

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation
• Ohmh, LLC

  dba Orlando Health Melbourne Hospital

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1033937883
  Care Compare affiliation
• Viera Hospital Inc

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1730494816
  Care Compare affiliation

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1669648754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410185",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329410185",
            "telephone_number": "407-451-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3491 TITANIC CIR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329031871",
            "telephone_number": "407-451-0192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2194 Highway A1A Ste 106",
            "address_purpose": "LOCATION",
            "city": "Indian Harbour Beach",
            "state": "FL",
            "postal_code": "329374955",
            "country_code": "US",
            "telephone_number": "321-794-5095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREYSLAK",
        "first_name": "DALE",
        "middle_name": "PHILLIP",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Indialantic, FL
• Providers in Indialantic, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.