Individual provider Active NPI

William Haynie Ausmus, PA

  • Physician Assistant
  • Largo, FL
National Provider Identifier
1770580490
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2141 Issued in FL
Practice address
148 13TH Street SW
Largo, FL 33770
Phone
(727) 581-8706
Fax
(727) 586-3743
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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 PA2141 FL Primary

Addresses

Primary practice location

148 13TH Street SW
Largo, FL 33770

Mailing address

PO Box 2410
Largo, FL 33779-2410
Phone (727) 581-8706

Other identifiers 1

IdentifierTypeStateIssuer
291846300MedicaidFL

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
I20040607000991 FL Practitioner - Physician Assistant 9436131968 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2141FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medikwa, Inc CurrentSince Jan 1, 2026 Accepting new patients
The Eye Physicians of Pinellas, PA Past Accepting new patients

Locations

3920 Bee Ridge Rd
Ste A-A
Sarasota, FL 34233
Phone (941) 867-7463

Organizations & group practices 2

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1770580490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2410",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337792410",
            "telephone_number": "727-581-8706",
            "fax_number": "727-586-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 13TH STREET SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33770",
            "telephone_number": "727-581-8706",
            "fax_number": "727-586-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSMUS",
        "first_name": "WILLIAM",
        "middle_name": "HAYNIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291846300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.