Annamarie Kisgeropoulos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9112758 Issued in FL

Practice address

305 Memorial Medical Pkwy Ste 206
Daytona Beach, FL 32117-5169

Phone

(407) 384-7388

Fax

(407) 384-1140

NPI assigned

Nov 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• Adventhealth Deland Hospital, Deland, FL, CCN 100045
• Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: akisgeropoulos70850@adventhealth.direct-ci.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.

• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Colon & Rectal Surgery

  Medicare reassignment Care Compare group NPD
• Digestive and Liver Center of FL, LLC

  • Gastroenterology Physician
  • Orlando, FL
  • NPI 1083742357
  Medicare reassignment
• Img Medical Group de PA

  • Sports Medicine (Family Medicine) Physician
  • Boynton Beach, FL
  • NPI 1720708589
  Medicare reassignment
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

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

• Memorial Health Systems Inc

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Memorial Hospital-West Volusia Inc

  • General Acute Care Hospital
  • Deland, FL
  • NPI 1649367269
  Care Compare affiliation
• Southwest Volusia Healthcare Corporation

  • General Acute Care Hospital
  • Orange City, FL
  • NPI 1700978558
  Care Compare affiliation
• Southwest Volusia Healthcare Corporation

  • Internal Medicine Physician
  • Orange City, FL
  • NPI 1902095078

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1962047670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6213 WOODHAVEN VILLAGE DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286850",
            "telephone_number": "386-341-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 206",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175169",
            "telephone_number": "407-384-7388",
            "fax_number": "407-384-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISGEROPOULOS",
        "first_name": "ANNAMARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "9112758",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Kinney
• Anthony Kinsey
• Kierra Imani Kinsey
• Susan Kinsey, PA-C
• Denise Kirkpatrick, CNA
• Chaz Kisgeropoulos
• Kist Alf, Inc
• Kim Arlan Klancke, MD
• Glendalyn Klein, M.D.,B.S.N.,R.N.
• James A Klein, M.D.

• Physician Assistant in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2025; 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.