Individual provider Active NPI

Sonal Dave, PA-C

  • Physician Assistant
  • Apopka, FL
National Provider Identifier
1861626822
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104792 Issued in FL
Practice address
2200 E Semoran Blvd Ste 2226
Apopka, FL 32703-5733
Phone
(407) 788-6399
Fax
(407) 788-0404
NPI assigned
May 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104792 FL Primary

Addresses

Primary practice location

2200 E Semoran Blvd Ste 2226
Apopka, FL 32703-5733

Mailing address

2200 E Semoran Blvd Ste 2226
Apopka, FL 32703-5733
Phone (407) 362-8032

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
I20100209000192 FL Practitioner - Physician Assistant 9335282698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

1345 W Bay Dr
202 Optum Largo
Largo, FL 33770-2276
Phone (727) 559-0895

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9104792FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida, LLC CurrentSince Jan 1, 2014 Accepting new patients
Optumcare Florida LLC CurrentSince Jan 1, 2014 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

201 N Park Ave
Ste 200
Apopka, FL 32703
Phone (407) 880-0011

2200 E Semoran Blvd
Ste 2226
Apopka, FL 32703
Phone (407) 788-6399

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: sonal.dave@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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 4

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": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1861626822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E SEMORAN BLVD STE 2226",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035733",
            "telephone_number": "407-362-8032",
            "fax_number": "407-880-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E SEMORAN BLVD STE 2226",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035733",
            "telephone_number": "407-788-6399",
            "fax_number": "407-788-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "SONAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.