Wynde Goins, PA-C
Individual provider Active NPI Physician Assistant · Saint Augustine, FL
NPI 1730573155 · NPPES record last updated Nov 21, 2022
Key facts
- NPI
- 1730573155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 9103181 (FL)
- Practice address
- 207 San Marco Ave
Saint Augustine, FL 32084-2762 - Phone
- (904) 827-2410
- NPI assigned
- Mar 24, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Wake Forest University School of Medicine, 1996
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
200 San Sebastian VW
St Augustine, FL 32084-8695
2200 Ringling Blvd
Sarasota, FL 34237-6199
4052 Bald Cypress Way
Tallahassee, FL 32399-7017
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260406000172 | FL | Practitioner - Physician Assistant | 1254806581 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9103181 | FL | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9103181 | FL | Yes |
Addresses
Primary practice location
207 San Marco Ave
Saint Augustine, FL 32084-2762
Mailing address
3428 Kings Rd S
Saint Augustine, FL 32086-5078
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA9103181 | Other | FL | FL PA LICENSE |
Other providers in Saint Augustine, FL
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- David S Goins
- David Brett Goldberg
- Glenn Marshall Goldberg
- Allison Ann Goldfarb
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All providers in Saint Augustine, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.