Individual provider Active NPI

Michael Barrera

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1669833232
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108964 Issued in FL
Practice address
1507 Park Center Dr Ste 1D
Orlando, FL 32835-5795
Phone
(407) 445-9445
Fax
(407) 293-3908
NPI assigned
Mar 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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 PA9108964 FL Primary

Addresses

Primary practice location

1507 Park Center Dr Ste 1D
Orlando, FL 32835-5795

Mailing address

151 Southhall LN Ste 300
Maitland, FL 32751-7172
Phone (407) 875-2080

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
I20160509000668 FL Practitioner - Physician Assistant 2365741600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

14050 Town Loop Blvd
Suite 203
Orlando, FL 32837-6190
Phone (407) 852-6650

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

1507 Park Ctr Dr
Suite 1D
Orlando, FL 32835-5795
Phone (407) 445-9445

2868 S Alafaya TRL
Suite 130
Orlando, FL 32828-7974
Phone (407) 770-0063

2893 Enterprise Rd
Suite 100
Debary, FL 32713-2784
Phone (386) 789-8600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9108964FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 15, 2016 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Mar 15, 2016 Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients

Locations

1905 Clint Moore Rd
Ste 103
Boca Raton, FL 33496
Phone (561) 241-4474

2893 Enterprise Rd
Ste 100
Debary, FL 32713
Phone 3867898600 ext. 38678

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1507 Park Center Dr
Ste 1D
Orlando, FL 32835
Phone (407) 445-9445

14050 Town Loop Blvd
Ste 203
Orlando, FL 32837
Phone (407) 852-6650

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457568000000",
    "number": "1669833232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 PARK CENTER DR STE 1D",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355795",
            "telephone_number": "407-445-9445",
            "fax_number": "407-293-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRERA",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.