Demittre Andre Anthony Sorenson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9114808 Issued in FL

Practice address

740 Concourse Pkwy S Ste 200
Maitland, FL 32751-8101

Phone

(407) 644-4014

NPI assigned

Jun 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

84.5 of 100Reported as group

Quality

69.32

Promoting interoperability

100

Improvement activities

40

Cost

72.03

Merit-based Incentive Payment System (MIPS)

Final score

85.21 of 100Reported as group

Quality

77.38

Improvement activities

40

Cost

77.2

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 and National Provider Directory roles.

• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962
  Medicare reassignment NPD
• Cfagi, LLC

  • Gastroenterology Physician
  • Maitland, FL
  • NPI 1467901520
  Medicare reassignment
• Tenet Florida Physician Services LLC

  • Surgery Physician
  • West Palm Beach, FL
  • NPI 1659417467
  Medicare reassignment
• Tenet Florida Physician Services, LLC

  • Physical Therapist
  • West Palm Beach, FL
  • NPI 1699111211
  NPD

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1881264455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 CONCOURSE PKWY S STE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327518101",
            "telephone_number": "407-644-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "DEMITTRE",
        "middle_name": "ANDRE ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9114808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111483000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel N Smith III, D.O.
• Stephanie Smith, LCSW
• Tia Marie Solh, PA
• Solutions Counseling & Consulting Inc
• Liberty A Sordia
• Aida Iris Soto, OT
• Spectrum Learner Lab, LLC
• Spectrum Rehabilitation and Wellness Inc.
• Speech & Language Pathology of C. FL., Inc
• Gharland Arno Spence Jr.

• Medical Physician Assistant in Maitland, FL
• Providers in Maitland, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.