Individual provider Active NPI

Andrea Lindsey McCollum, PA-C

  • Physician Assistant
  • Gainesville, FL
National Provider Identifier
1679193825
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113189 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(912) 399-9227
NPI assigned
Apr 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 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 PA9113189 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

1600 SW Archer Rd
Box 1001008
Gainesville, FL 32653
Phone (352) 273-5670

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
I20200603002613 FL Practitioner - Physician Assistant 9133540958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 276-8500

6500 Newberry Rd
North Florida Regional Medical Center
Gainesville, FL 32605-4309
Phone (352) 333-2013

6500 W Newberry Rd
Gainesville, FL 32605-4309
Phone (561) 997-0821

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9113189FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jun 15, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 15, 2020 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Dec 1, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Dec 1, 2025 Accepting new patients
Robert Lee Harrell III MD PC PastSince Dec 26, 2021 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

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

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

Organizations & group practices 7

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": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1679193825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 1001008",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32653",
            "telephone_number": "352-273-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "912-399-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "ANDREA",
        "middle_name": "LINDSEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.