Active NPI
David W. Indarawis, PA-C
- Physician Assistant
- Gainesville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9103773
- Practice address
- 1600 SW Archer Rd
Gainesville, FL 32610-3003 - Phone
- (352) 265-5911
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA.0005528 | CO | |
| Physician Assistant | 363A00000X | PA9103773 | FL | Primary |
Addresses
Primary practice location
1600 SW Archer Rd
Gainesville, FL 32610-3003
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Other practice location 1
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 265-5911
Other practice location 2
12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292503600 | Medicaid | FL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9103773 | FL | MD | Physician Assistant |
| PA.0005528 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FL - I Medical Services LLC | Physician Assistant | Current | Accepting new patients |
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| FL-I Medical Services LLC | Physician Assistant | Current | Accepting new patients |
| Dolphin Emergency Physicians LLC | Past | Accepting new patients | |
| Florida Em-I Medical Services PA | Past | Accepting new patients | |
| Emergency Physicians of St. Johns County | Past | Accepting new patients | |
| Magnolia Emergency Physicians LLC | Physician Assistant | Past | Accepting new patients |
Locations
2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303
322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858
996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
1600 SW Archer Rd
#1003
Gainesville, FL 32610
6500 W Newberry Rd
Gainesville, FL 32605
Phone (352) 333-4180
20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290
449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900
922 E Call St
Starke, FL 32091
Phone (904) 368-2300
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- dindarawis16442@direct.shands.ufl.edu
Organizations & group practices 10
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.
-
- Surgery Physician
- Gainesville, FL
- NPI 1063463768
-
- Emergency Medicine Physician
- Aventura, FL
- NPI 1043917180
-
- Nurse Practitioner
- Fort Pierce, FL
- NPI 1750655106
-
- Physician Assistant
- Haines City, FL
- NPI 1285356790
-
- Durable Medical Equipment & Medical Supplies
- Ocala, FL
- NPI 1609529478
-
- Emergency Medicine Physician
- Ocala, FL
- NPI 1871542712
-
- Emergency Medicine Physician
- St Augustine, FL
- NPI 1801881818
-
- Emergency Medicine Physician
- Ocala, FL
- NPI 1881643740
-
- Emergency Medicine Physician
- Ocala, FL
- NPI 1164471090
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1912913468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110429",
"city": "AURORA",
"state": "CO",
"postal_code": "800420429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326103003",
"telephone_number": "352-265-5911"
}
],
"practiceLocations": [
{
"address_1": "1600 SW Archer Rd",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "FL",
"postal_code": "326103003",
"country_code": "US",
"telephone_number": "352-265-5911",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12605 E 16th Ave",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "80045",
"country_code": "US",
"telephone_number": "720-848-0000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "INDARAWIS",
"first_name": "DAVID",
"middle_name": "W.",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "PA.0005528",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9103773",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292503600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.