NPIMap

Individual provider Active NPI

Salim A Ghorayeb, PA-C

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1750632410
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9106752 Issued in FL
Practice address
89 W Copeland Dr
Orlando, FL 32806
Phone
(321) 841-7550
Fax
(321) 841-8185
NPI assigned
Sep 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9106752 FL Primary

Addresses

Primary practice location

89 W Copeland Dr
Orlando, FL 32806

Mailing address

89 W Copeland Dr
Orlando, FL 32806-2002
Phone (321) 841-7550

Other practice location 1

305 Memorial Medical Pkwy
Suite 206
Daytona Beach, FL 32117
Phone (386) 231-3540

Other identifiers 1

IdentifierTypeStateIssuer
007279100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AZ, CO3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20121212000358 FL Practitioner - Physician Assistant 2062664303 Reassigns benefits to 1 organization
I20180507000618 AZ Practitioner - Physician Assistant 2062664303 Reassigns benefits to 1 organization
I20201020002249 CO Practitioner - Physician Assistant 2062664303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 2, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 2, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 1, 2018 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 1, 2018 Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients
Clover Emergency Physicians LLC Past Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients

Locations

1520 S Dobson Rd
Ste 203
Mesa, AZ 85202
Phone (480) 412-8080

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

750 Wellington Ave
Ste 3A
Grand Junction, CO 81501
Phone (970) 248-3188

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

89 W Copeland Dr
Orlando, FL 32806
Phone (407) 237-6333

Organizations & group practices 9

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 10

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": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1750632410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 W COPELAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062002",
            "telephone_number": "321-841-7550",
            "fax_number": "321-841-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 W COPELAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32806",
            "telephone_number": "321-841-7550",
            "fax_number": "321-841-8185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Memorial Medical Pkwy",
            "address_2": "Suite 206",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "32117",
            "country_code": "US",
            "telephone_number": "386-231-3540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHORAYEB",
        "first_name": "SALIM",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007279100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.