Individual provider Active NPI

Kwabena Amponsah, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1891958195
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104033 Issued in FL
Practice address
9145 Narcoossee Rd Ste 102
Orlando, FL 32827-5768
Phone
(407) 703-6020
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3771 WI
Surgical Physician Assistant 363AS0400X PA9104033 FL
Physician Assistant 363A00000X PA9104033 FL Primary

Addresses

Primary practice location

9145 Narcoossee Rd Ste 102
Orlando, FL 32827-5768

Mailing address

9145 Narcoossee Rd Ste 102
Orlando, FL 32827-5768

Other practice location 1

2501 N Orange Ave Ste 201
Orlando, FL 32804-4641
Phone (407) 821-3550

Other practice location 2

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 868-5871

Other practice location 3

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585
Phone (321) 868-5871

Other identifiers 4

IdentifierTypeStateIssuer
1891958195MedicaidWI
113315300MedicaidFL
UO290OtherFLMEDICARE HF
UO289OtherFLMEDICARE HFPS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kamponsah383151@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120207000687 FL Practitioner - Physician Assistant 8426215161 Reassigns benefits to 3 organizations
I20160819001533 WI Practitioner - Physician Assistant 8426215161 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-1401

1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone (321) 434-8121

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585
Phone (321) 799-7128

8725 N Wickham Rd
Melbourne, FL 32940-2240

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-5162

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9104033FLMDPhysician Assistant
3771WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Oct 5, 2020 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 19, 2017 Accepting new patients
Dean Health Systems, Inc CurrentSince Oct 5, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 18, 2022 Accepting new patients
Health First Medical Group, LLC CurrentSince Mar 24, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 19, 2017 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Sep 17, 2018 Accepting new patients
Health First Medical Group, LLC CurrentSince Mar 24, 2025 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Jan 18, 2022 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Sep 17, 2018 Accepting new patients
Marshfield Clinic Inc CurrentSince Sep 17, 2018 Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 505
Cocoa Beach, FL 32931
Phone (321) 783-1133

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931
Phone (321) 799-7111

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

8725 N Wickham Rd
Ste 302
Melbourne, FL 32940
Phone (321) 434-9230

2501 N Orange Ave
Ste 201
Orlando, FL 32804
Phone (407) 303-5214

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

8745 N Wickham Rd
Viera, FL 32940
Phone (321) 434-7191

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: kamponsah383151@direct-ehr-ssmhc.com

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1891958195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9145 NARCOOSSEE RD STE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328275768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9145 NARCOOSSEE RD STE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328275768",
            "telephone_number": "407-703-6020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 N Orange Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328044641",
            "country_code": "US",
            "telephone_number": "407-821-3550",
            "fax_number": "407-821-3551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8745 N Wickham Rd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329405997",
            "country_code": "US",
            "telephone_number": "321-868-5871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 W Cocoa Beach Cswy",
            "address_purpose": "LOCATION",
            "city": "Cocoa Beach",
            "state": "FL",
            "postal_code": "329313585",
            "country_code": "US",
            "telephone_number": "321-868-5871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMPONSAH",
        "first_name": "KWABENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3771",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104033",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891958195",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113315300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "UO290",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HFPS",
            "identifier": "UO289",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kamponsah383151@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kamponsah383151@direct-ehr-ssmhc.com",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.