Benjamin Roland Crumley, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9106161 Issued in FL

Practice address

1222 S Orange Ave
Orlando, FL 32806-1215

Phone

(321) 841-7700

Fax

(321) 841-7799

NPI assigned

Feb 10, 2009

Sex

Male

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 2

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Florida Cardiology Network, LLCGroup PAC ID 8729260641, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Northside Hospital Hospital, Saint Petersburg, FL, CCN 100238

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: benjamin.crumley@hca4.eclinicaldirectplus.com

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.

• West Florida Cardiology Network, LLC

  • Cardiovascular Disease Physician
  • Saint Petersburg, FL
  • NPI 1801198023
  Medicare reassignment Care Compare group
• Cardiology Consultants

  • Specialist
  • St Petersburg, FL
  • NPI 1811940802
  NPD (past)
• Cardiovascular Surgeons, P.a.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Orlando, FL
  • NPI 1912904111
  NPD (past)
• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Galencare, Inc.

  • General Acute Care Hospital
  • St Petersburg, FL
  • NPI 1205880945
  Care Compare affiliation

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1891934154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-7700",
            "fax_number": "321-841-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-7700",
            "fax_number": "321-841-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMLEY",
        "first_name": "BENJAMIN",
        "middle_name": "ROLAND",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9106161",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014837200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Crozier
• Abigail Rochelle Crubaugh, DNP, CRNA
• Adora Crudo, PT
• Avery Lynne Crum
• Emily Crumbly
• Jacqueline Love Crump, ARNP
• Ann Crusius, CRNA
• Christopher L Crutcher, ARNP
• Rose Crutcher, M.D.
• Jeannette Lissette Cruz Acevedo

• Surgical Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.