Individual provider Active NPI

Craig David Quezada, PA-C

  • Physician Assistant
  • Coral Gables, FL
National Provider Identifier
1780451492
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.PA.61637735 Issued in WA
Practice address
2521 San Domingo St
Coral Gables, FL 33134-5560
Phone
(757) 750-5458
NPI assigned
Dec 4, 2023
Last updated
May 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.PA.61637735 WA Primary
Medical Physician Assistant 363AM0700X 9118229 FL

Addresses

Primary practice location

2521 San Domingo St
Coral Gables, FL 33134-5560

Mailing address

2521 San Domingo St
Coral Gables, FL 33134-5560
Phone (757) 750-5458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20240104004636 FL Practitioner - Physician Assistant 0244681195 Reassigns benefits to 1 organization
I20250314002055 WA Practitioner - Physician Assistant 0244681195 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nexus Consultants LLCGroup PAC ID 9537547617, 7 clinicians

Practice addresses (Care Compare)

32104 116TH Ave SE
Auburn, WA 98092-4841
Phone (830) 285-8882

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64994CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PA.PA.61637735WAMDPhysician Assistant
9118229FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wa Alliance Wound Care Services PLLC CurrentSince Nov 7, 2025 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1780451492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 SAN DOMINGO ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345560",
            "telephone_number": "757-750-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 SAN DOMINGO ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345560",
            "telephone_number": "757-750-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEZADA",
        "first_name": "CRAIG",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-04",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA.PA.61637735",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9118229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.