Individual provider Active NPI

Rachel Rosol, PA-C

  • Physician Assistant
  • Tavares, FL
National Provider Identifier
1801661699
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117989 Issued in FL
Practice address
3330 Waterman Way
Tavares, FL 32778-5250
Phone
(352) 385-3022
NPI assigned
Nov 21, 2023
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X PA9117989 FL
Physician Assistant 363A00000X PA9117989 FL Primary

Addresses

Primary practice location

3330 Waterman Way
Tavares, FL 32778-5250

Mailing address

3330 Waterman Way
Tavares, FL 32778-5250
Phone (352) 385-3022

Other practice location 1

3310 Waterman Way
Tavares, FL 32778-5250
Phone (352) 385-3022

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
I20240129004103 FL Practitioner - Physician Assistant 1456704113 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Jan 29, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 29, 2024 Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

3310 Waterman Way
Tavares, FL 32778
Phone (352) 343-1216

3330 Waterman Way
Tavares, FL 32778
Phone (352) 385-3022

Interoperability endpoints

  • Direct secure messaging: rrosol163539@direct.nemours.org

Organizations & group practices 3

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": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1801661699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785250",
            "telephone_number": "352-385-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785250",
            "telephone_number": "352-385-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3310 Waterman Way",
            "address_purpose": "LOCATION",
            "city": "Tavares",
            "state": "FL",
            "postal_code": "327785250",
            "country_code": "US",
            "telephone_number": "352-385-3022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSOL",
        "first_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "PA9117989",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.