Active NPI
Theron D Hawkins, PAC
- Medical Physician Assistant
- Dunedin, FL
National Provider Identifier
1851345201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 9101296
- Practice address
- 703 Virginia St
Dunedin, FL 34698-6615 - Phone
- (727) 734-4000
- Fax
- (727) 734-4454
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 9101296 | FL | Primary |
Addresses
Primary practice location
703 Virginia St
Dunedin, FL 34698-6615
Mailing address
703 Virginia St
Dunedin, FL 34698-6615
Phone (727) 734-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y00YE | Other | FL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040812000769 | FL | Practitioner - Physician Assistant | 1153393798 | Reassigns benefits to 2 organizations |
| I20251029001873 | WI | Practitioner - Physician Assistant | 1153393798 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- American Current Care PA
Practice addresses (Care Compare)
2455 N 124TH St
Brookfield, WI 53005-4630
Phone (262) 782-9326
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9101296 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Current Care P.a. | Current | Accepting new patients | |
| American Current Care PA | Current | Accepting new patients | |
| American Current Care P.a. | Current | Accepting new patients | |
| American Current Care P.a. | Current | Accepting new patients | |
| American Current Care PA | Current | Accepting new patients | |
| Franklin, Favata & Hulls, MD'S, PA | Past | Accepting new patients | |
| Advanced Wound Systems LLC | Past | Accepting new patients | |
| Nautilus Health Care Group, LLC | Past | Accepting new patients |
Locations
2455 N 124th St
Brookfield, WI 53005
Phone (262) 782-9326
358 Junction Rd
Madison, WI 53717
Phone (608) 829-1888
215 N 35th St
Milwaukee, WI 53208
Phone (414) 931-7600
Organizations & group practices 33
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359417600000",
"number": "1851345201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 VIRGINIA ST",
"city": "DUNEDIN",
"state": "FL",
"postal_code": "346986615",
"telephone_number": "727-734-4000",
"fax_number": "727-734-4454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 VIRGINIA ST",
"city": "DUNEDIN",
"state": "FL",
"postal_code": "346986615",
"telephone_number": "727-734-4000",
"fax_number": "727-734-4454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWKINS",
"first_name": "THERON",
"middle_name": "D",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2013-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA 9101296",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Y00YE",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dunedin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.