Individual provider Active NPI

Donald J Huggard, PA

  • Physician Assistant
  • Edgewater, FL
National Provider Identifier
1700870177
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3292 Issued in FL
Practice address
812 W Indian Blvd.
Edgewater, FL 32132-3429
Phone
(386) 426-1411
Fax
(386) 426-1411
NPI assigned
Aug 31, 2005
Last updated
Apr 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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 PA3292 FL Primary

Addresses

Primary practice location

812 W Indian Blvd.
Edgewater, FL 32132-3429

Mailing address

2950 Sunset Dr
New Smyrna Beach, FL 32168-5616
Phone (386) 871-5708

Other identifiers 2

IdentifierTypeStateIssuer
IB111ZOtherFLMEDICARE PTAN
001658OtherFLFLORIDA HEALTH CARE

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
I20100826000252 FL Practitioner - Physician Assistant 5991866055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Smyrna Orthopedics PAGroup PAC ID 2365417391, 2 clinicians

Practice addresses (Care Compare)

812 Indian River Blvd
Edgewater, FL 32132-3429
Phone (386) 426-1411

812 W Indian River Blvd
Edgewater, FL 32132-3429

Hospital & facility affiliations

National Provider Directory

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1700870177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 SUNSET DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321685616",
            "telephone_number": "386-871-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W INDIAN BLVD.",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321323429",
            "telephone_number": "386-426-1411",
            "fax_number": "386-426-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGGARD",
        "first_name": "DONALD",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IB111Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA HEALTH CARE",
            "identifier": "001658",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, FL

Sources for this page

Verify at the official NPI Registry.