Diana C Obradovic, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102499 Issued in FL

Practice address

4343 W Newberry Rd
Suite 10
Gainesville, FL 32607-2825

Phone

(352) 373-2340

Fax

(352) 373-3140

NPI assigned

Jan 13, 2006

Last updated

Aug 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Diana Christie Olsen Peterson Former name

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Simedhealth LLCGroup PAC ID 6608137054, 89 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83 of 100Reported as group

Quality

65.57

Promoting interoperability

99

Improvement activities

40

Cost

78.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Simedhealth LLC

  • Internal Medicine Physician
  • Gainesville, FL
  • NPI 1639680127
  Medicare reassignment Care Compare group
• Simed Health LLC

  dba SIMEDHEALTH Pharmacy

  • Community/Retail Pharmacy
  • Gainesville, FL
  • NPI 1376616698
  NPD

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1841279148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-416-1082",
            "fax_number": "352-373-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W NEWBERRY RD",
            "address_2": "SUITE 10",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072825",
            "telephone_number": "352-373-2340",
            "fax_number": "352-373-3140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 SW Highway 484 Ste 105",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344731996",
            "country_code": "US",
            "telephone_number": "352-693-5900 x35269",
            "fax_number": "352-693-5805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBRADOVIC",
        "first_name": "DIANA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122670500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "PETERSON",
            "middle_name": "CHRISTIE OLSEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blake Elizabeth Oberfeld, MD
• Madeline Grace Oberg
• Alyssa Obermiller, DO
• Wayne W. Oberti, MD
• Faith Obimdike, MD
• Mathew Obrien, MSW
• Thomas Richard Obrien, LPN
• Arnold Obungu, MD
• Ocala Kidney Group Inc
• Mary Rose Alfuente Ocampo, PHARMD

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.