Individual provider Active NPI

William Bresette, PA-C, RDN

  • Physician Assistant
  • Lutz, FL
National Provider Identifier
1700579661
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121995 Issued in FL
Practice address
15953 N Florida Ave
Lutz, FL 33549-8102
Phone
(813) 513-0808
NPI assigned
May 29, 2023
Last updated
Jul 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9121995 FL Primary
Registered Dietitian 133V00000X ND11563 FL

Addresses

Primary practice location

15953 N Florida Ave
Lutz, FL 33549-8102

Mailing address

15953 N Florida Ave
Lutz, FL 33549-8102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3715 Northside Parkside
Building 100 Suite 550
Atlanta, GA 30327-2886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND11563FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jul 17, 2026 Accepting new patients

Locations

15953 N Florida Ave
Lutz, FL 33549
Phone (813) 513-0808

Organizations & group practices 1

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": "1685318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1700579661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15953 N FLORIDA AVE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335498102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15953 N FLORIDA AVE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335498102",
            "telephone_number": "813-513-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESETTE",
        "first_name": "WILLIAM",
        "credential": "PA-C, RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-29",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121995",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND11563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.