Individual provider Active NPI

Andrea N McGannon, PA-C

  • Physician Assistant
  • Stuart, FL
National Provider Identifier
1821601493
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116067 Issued in FL
Practice address
2100 SE Salerno Rd
Stuart, FL 34997-6503
Phone
(772) 781-2735
Fax
(772) 781-2739
NPI assigned
Aug 25, 2020
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA9116067 FL Primary

Addresses

Primary practice location

2100 SE Salerno Rd
Stuart, FL 34997-6503

Mailing address

3634 NW Adriatic LN
Jensen Beach, FL 34957-3111
Phone (440) 391-7017

Other practice location 1

275 Eastland Rd
Berea, OH 44017-2005
Phone (440) 826-6543

Other practice location 2

1050 SE Monterey Rd Ste 400
Stuart, FL 34994-4512
Phone (772) 288-2400

Other practice location 3

9401 SW Discovery Way Ste 201
Port Saint Lucie, FL 34987-2381
Phone (772) 288-2400

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
I20220915003492 FL Practitioner - Physician Assistant 7315322096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 SE Monterey Rd
Stuart, FL 34994-4512

9955 SE Federal Hwy
Hobe Sound, FL 33455-4800
Phone (772) 288-2400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.26 of 100Reported as apm
Quality
80.2
Promoting interoperability
99.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9116067FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
South Florida Orthopaedics & Sports Medicine, PA CurrentSince Jul 12, 2023 Accepting new patients
South Florida Orthopaedics & Sports Medicine,PA Past Accepting new patients

Locations

1881 SE Tiffany Ave
Ste 202
Port St Lucie, FL 34952

9401 SW Discovery Way
Ste 201
Port St Lucie, FL 34987

1050 SE Monterey Rd
Ste 400
Stuart, FL 34994

Interoperability endpoints

  • Direct secure messaging: amcgannon2496328@direct.ccf.org
  • Direct secure messaging: andrea.mcgannonpa.d1.p1@direct.southflaortho.nextgenshare.com

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.

Hospital & facility affiliations 3

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": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1821601493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3634 NW ADRIATIC LN",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573111",
            "telephone_number": "440-391-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE SALERNO RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976503",
            "telephone_number": "772-781-2735",
            "fax_number": "772-781-2739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Eastland Rd",
            "address_purpose": "LOCATION",
            "city": "Berea",
            "state": "OH",
            "postal_code": "440172005",
            "country_code": "US",
            "telephone_number": "440-826-6543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 SE Monterey Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944512",
            "country_code": "US",
            "telephone_number": "772-288-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9401 SW Discovery Way Ste 201",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349872381",
            "country_code": "US",
            "telephone_number": "772-288-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGANNON",
        "first_name": "ANDREA",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.