Ryan A Demello

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9119356 Issued in FL

Practice address

2955 Brownwood Blvd Ste 204
The Villages, FL 32163-2040

Phone

(866) 400-3376

Fax

(352) 877-3354

NPI assigned

Sep 12, 2024

Sex

Male

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 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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Leavitt Medical Associates of Florida Inc

  • Dermatology Physician
  • Sebastian, FL
  • NPI 1083872535
  Medicare reassignment Care Compare group NPD
• Leavitt Medical Associates of Florida Inc

  • Dermatology Physician
  • Ocala, FL
  • NPI 1952534182
  NPD
• Leavitt Medical Associates of Florida Inc

  • Dermatology Physician
  • Heathrow, FL
  • NPI 1528097284
  NPD (past)

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1780410043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "866-400-3376",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 BROWNWOOD BLVD STE 204",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321632040",
            "telephone_number": "866-400-3376",
            "fax_number": "352-877-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMELLO",
        "first_name": "RYAN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerard Deib
• Delcare, PA
• Jonathan Antonio Delfin, LCSW
• Madelyn Delgado Borges, APRN
• Neutt Dellareeda, MSN, APRN, FNP-BC
• Sarah Denion
• Carolyne B. Denonno, CL,ASCP,COE
• Dermatology Institute and Skin Cancer Center LLC
• Laura Erika Dermenjian, PA
• Derrick J Martin MD PA

• Physician Assistant in The Villages, FL
• Providers in The Villages, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.