Elyse Marie Chaviano, MD
Individual provider Active NPI Pediatrics Physician · Gainesville, FL
NPI 1902233554 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1902233554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- ME154778 (FL)
- Practice address
- 1600 SW Archer Rd
Gainesville, FL 32610-3009 - Phone
- (352) 627-9350
- NPI assigned
- Sep 27, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 47.54 of 100
- Quality
- 38.49
- Promoting interoperability
- 0
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220809001495 | FL | Practitioner - Pediatric Medicine | 4880926344 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9107539 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Current |
Accepting new patients | |
| Florida Clinical Practice Association Inc | Current |
Accepting new patients |
Locations
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
133 SW 130th Way
Ste C
Newberry, FL 32669
Phone (352) 594-1500
Interoperability endpoints
- echaviano189022@direct.shands.ufl.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9107539 | FL | |
| Pediatrics Physician | 208000000X | ME154778 | FL | Yes |
Addresses
Primary practice location
1600 SW Archer Rd
Gainesville, FL 32610-3009
Mailing address
PO Box 100296
Gainesville, FL 32610-0296
Phone (352) 627-9350
Other practice location 1
3100 SW 62nd Ave
Miami, FL 33155-3009
Phone (305) 662-8357
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113796000 | Medicaid | FL |
Other providers in Gainesville, FL
- Grecia Chavez Betancourt
- Chase Hsing Chavez
- Elena Chavez
- Ma Luz Prias Chavez
- Ricardo Chavez
- CHC of Gainesville, LLC
- Mabel Mambo Che-Tuma
- Fru Che
- Tram Thi Thu Che
- Victoria Larranaga Cheatwood
All providers in Gainesville, FL · Pediatrics Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.