Individual provider Active NPI

Dana N. Brendel, P.A.

  • Medical Physician Assistant
  • Largo, FL
National Provider Identifier
1821283102
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104325 Issued in FL
Practice address
13670 Walsingham Rd
Largo, FL 33774-3532
Phone
(727) 593-9848
Fax
(727) 596-4532
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104325 FL
Medical Physician Assistant 363AM0700X PA9109434 FL
Medical Physician Assistant 363AM0700X PA9104325 FL Primary

Addresses

Primary practice location

13670 Walsingham Rd
Largo, FL 33774-3532

Mailing address

13670 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 593-9848

Other practice location 1

501 6th Ave S
Dept 6610
St Petersburg, FL 33701-4634
Phone (727) 767-4196

Other identifiers 1

IdentifierTypeStateIssuer
016380800MedicaidFL

Other names 1

  • Miss Dana N. White Former name

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104325FLMDMedical Physician Assistant
PA9109434FLMDMedical Physician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dana.brendelpa-c@direct.mybaycare.org

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1821283102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13670 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-593-9848",
            "fax_number": "727-596-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13670 WALSINGHAM RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743532",
            "telephone_number": "727-593-9848",
            "fax_number": "727-596-4532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 6th Ave S",
            "address_2": "Dept 6610",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337014634",
            "country_code": "US",
            "telephone_number": "727-767-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENDEL",
        "first_name": "DANA",
        "middle_name": "N.",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104325",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109434",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016380800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "WHITE",
            "middle_name": "N.",
            "prefix": "MISS",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.