Individual provider Active NPI

Mitchell Arthur Joseph Gullifer, PA

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1730760257
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4725 US Highway 98 S Ste 101-102
Lakeland, FL 33812-4334
Phone
(863) 274-9700
Fax
(863) 328-9700
NPI assigned
Apr 16, 2021
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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 NU Primary

Addresses

Primary practice location

4725 US Highway 98 S Ste 101-102
Lakeland, FL 33812-4334

Mailing address

3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

Other practice location 1

721 W Robertson St Ste 102
Brandon, FL 33511-4900
Phone (813) 684-3707

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
I20210908003565 FL Practitioner - Physician Assistant 5698171171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2605 Welaunee Blvd
Tallahassee, FL 32308-4697
Phone (850) 877-8174

3051 6TH St
Marianna, FL 32446-1933
Phone (850) 526-3236

3334 Capital Medical Blvd
Suite 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

4725 US Hwy 98 S
Suite 101 102
Lakeland, FL 33812-4334
Phone (813) 978-9700

Merit-based Incentive Payment System (MIPS)

Final score
76.5 of 100Reported as group
Quality
47.27
Promoting interoperability
99
Improvement activities
40
Cost
75.24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Musculoskeletal Institute Chartered CurrentSince Dec 18, 2025 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Aug 23, 2021 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Dec 18, 2025 Accepting new patients

Locations

721 W Robertson St
Brandon, FL 33511
Phone (813) 654-1410

721 W Robertson St
Ste 102
Brandon, FL 33511
Phone (813) 684-3707

4725 US Highway 98 S
Ste 101102
Lakeland, FL 33812
Phone (863) 274-9700

3051 6th St
Marianna, FL 32446
Phone (850) 482-0017

3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mitchell.gullifer.1@18802.direct.athenahealth.com

Organizations & group practices 5

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": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1730760257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "844-261-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 US HIGHWAY 98 S STE 101-102",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124334",
            "telephone_number": "863-274-9700",
            "fax_number": "863-328-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 W Robertson St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114900",
            "country_code": "US",
            "telephone_number": "813-684-3707",
            "fax_number": "813-654-3671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULLIFER",
        "first_name": "MITCHELL",
        "middle_name": "ARTHUR JOSEPH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.