Individual provider Active NPI

Victoria Tirado Michiel, PA-C

  • Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1679172571
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113798 Issued in FL
Practice address
3264 Greenwald Way N
Kissimmee, FL 34741-0728
Phone
(407) 539-0312
Fax
(407) 539-0313
NPI assigned
Oct 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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 PA9113798 FL Primary

Addresses

Primary practice location

3264 Greenwald Way N
Kissimmee, FL 34741-0728

Mailing address

3264 Greenwald Way N
Kissimmee, FL 34741-0728
Phone (407) 539-0312

Other names 1

  • Victoria Tirado Former name

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
I20201119000184 FL Practitioner - Physician Assistant 3476964677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

2200 Fowler Grove Blvd
Suite 140
Winter Garden, FL 34787-5597
Phone (407) 614-0528

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113798FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Nov 30, 2020 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Nov 30, 2020 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

3264 Greenwald Way N
Kissimmee, FL 34741
Phone (407) 539-0312

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Interoperability endpoints

  • Direct secure messaging: vmichiel73708@adventhealth.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1679172571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-539-0312",
            "fax_number": "407-539-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-539-0312",
            "fax_number": "407-539-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHIEL",
        "first_name": "VICTORIA",
        "middle_name": "TIRADO",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "TIRADO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.