Individual provider Active NPI

Tulsi B Dave

  • Medical Physician Assistant
  • Leesburg, FL
National Provider Identifier
1902513310
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1181157 Issued in FL
Practice address
8136 Centralia CT Ste 103
Leesburg, FL 34788-3757
Phone
(352) 343-7246
NPI assigned
Nov 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1181157 FL Primary

Addresses

Primary practice location

8136 Centralia CT Ste 103
Leesburg, FL 34788-3757

Mailing address

3117 River Springs Boulverd
Clermont, FL 34711
Phone (551) 208-8824

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
I20230919002586 FL Practitioner - Physician Assistant 6204290505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Vision LLCGroup PAC ID 9032349733, 66 clinicians

Practice addresses (Care Compare)

6817 Southpoint Pkwy
Suite 203
Jacksonville, FL 32216-6286
Phone (904) 231-1204

7807 Baymeadows E Rd
Suite 209
Jacksonville, FL 32256-9666
Phone (904) 231-1204

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.1 of 100Reported as group
Quality
35.98
Promoting interoperability
100
Improvement activities
40
Cost
61.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1181157FLMDMedical Physician Assistant

Organizations & group practices 1

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": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1902513310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 RIVER SPRINGS BOULVERD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "551-208-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8136 CENTRALIA CT STE 103",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347883757",
            "telephone_number": "352-343-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "TULSI",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "1181157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.