Individual provider Active NPI

Andrew Beverly, PA-C

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1821461542
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9110333 Issued in FL
Practice address
25 W Crystal Lake St
Suite 200
Orlando, FL 32806-4475
Phone
(407) 254-2500
Fax
(407) 423-2789
NPI assigned
Nov 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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 TN
Medical Physician Assistant 363AM0700X PA9110333 FL Primary

Addresses

Primary practice location

25 W Crystal Lake St
Suite 200
Orlando, FL 32806-4475

Mailing address

25 W Crystal Lake St
Suite 200
Orlando, FL 32806-4475
Phone (407) 254-2500

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
I20170613001997 FL Practitioner - Physician Assistant 2769783687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Orlando Orthopaedic Center MD PAGroup PAC ID 3678562840, 45 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

2699 Lee Rd
Suite 100
Winter Park, FL 32789-1738
Phone (407) 897-1363

2911 Red Bug Lake Rd
Suite 100
Casselberry, FL 32707-5905
Phone (407) 699-9511

464 N Alafaya TRL
Suite 108
Orlando, FL 32828-4350
Phone (407) 398-6450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.31 of 100Reported as group
Quality
88.59
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9110333FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Orthopaedic Center MD PA CurrentSince Jun 19, 2017 Accepting new patients

Locations

2911 Red Bug Lake Rd
Casselberry, FL 32707
Phone (407) 699-9511

25 W Crystal Lake St
Ste 200
Orlando, FL 32806
Phone (407) 254-2500

2699 Lee Rd
Ste 100
Winter Park, FL 32789
Phone (407) 897-1363

Interoperability endpoints

  • Direct secure messaging: andrew.beverly.p1@direct.ooc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1821461542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W CRYSTAL LAKE ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064475",
            "telephone_number": "407-254-2500",
            "fax_number": "407-423-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W CRYSTAL LAKE ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064475",
            "telephone_number": "407-254-2500",
            "fax_number": "407-423-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERLY",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-03",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.