Individual provider Active NPI

Michael Dancy, CSFA, CST

  • Surgical Physician Assistant
  • Melbourne, FL
National Provider Identifier
1760888283
Registry record updated Nov 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
749 McDermott Ave
Melbourne, FL 32935-3038
Phone
(321) 890-2022
NPI assigned
Nov 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2014

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 Primary

Addresses

Primary practice location

749 McDermott Ave
Melbourne, FL 32935-3038

Mailing address

1270 N Wickham Rd Ste 16-422
Melbourne, FL 32935-8923
Phone (321) 890-2022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Space Coast Surgical Assisting LLC Surgical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1760888283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 N WICKHAM RD STE 16-422",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358923",
            "telephone_number": "321-890-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 MCDERMOTT AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353038",
            "telephone_number": "321-890-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCY",
        "first_name": "MICHAEL",
        "credential": "CSFA, CST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.