Kelly Elizabeth Demuynck, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9112731 Issued in FL

Practice address

305 Memorial Medical Pkwy Ste 308
Daytona Beach, FL 32117-5137

Phone

(678) 464-4466

NPI assigned

Feb 18, 2015

Last updated

Apr 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, WV, WI, IL, FL5 enrollments

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 5

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10114/brand/2/csg/1/fhir/r4

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.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Florida Hospital Healthcare Partners, Inc

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1780100529
  Medicare reassignment Care Compare group
• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077

  Physician Assistant

  Medicare reassignment NPD
• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Nchmd Inc

  • Hematology & Oncology Physician
  • Naples, FL
  • NPI 1831120195
  Medicare reassignment
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment
• Aspirus Riverview Hospital & Clinics, Inc.

  dba Aspirus Outpatient Therapies - Wisconsin Rapids

  • General Acute Care Hospital
  • Wisconsin Rapids, WI
  • NPI 1295754844
  Medicare reassignment
• West Virginia University Medical Corporation

  dba University Health Associates

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• Landmark Hospital of Southwest Florida, LLC

  • Long Term Care Hospital
  • Lehigh Acres, FL
  • NPI 1932595659
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1750772349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 308",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175137",
            "telephone_number": "678-464-4466",
            "fax_number": "816-531-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 308",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175137",
            "telephone_number": "678-464-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMUYNCK",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Deluca
• Delwin L Pitzer PSWD PA
• Jeffrey Stanton Demercurio, MD
• Suzanne M. Demming, M.D.
• Tamera Alexis Demps
• Kirk Andrew Denning, OTR/L
• Dental Creations of Daytona Beach
• Kenneth Derbenwick, MD
• Mary June Derbenwick, M.D.
• Caroline S Derensis, CRNA

• Physician Assistant in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.