Shelly Lynn Fradet, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3365 Issued in FL

Practice address

1404 S Ridgewood Ave
Edgewater, FL 32132-2720

Phone

(386) 426-8166

NPI assigned

Nov 30, 2006

Last updated

Sep 3, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Family Practice LLCGroup PAC ID 1850486085, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
• Adventhealth Home Health Home health agency, Ormond Beach, FL, CCN 107408
• Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Family Practice LLC

  • Family Medicine Physician
  • Edgewater, FL
  • NPI 1275552358
  Medicare reassignment Care Compare group

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

• Adventhealth Home Health and Hospice Inc

  dba Adventhealth Home Care East Florida

  • Home Health Agency
  • Ormond Beach, FL
  • NPI 1134161318
  Care Compare affiliation
• Altercare LLC

  dba Trilogy Home Healthcare

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1871529347
  Care Compare affiliation
• Memorial Health Systems Inc

  dba AdventHealth Daytona Beach

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

  dba AdventHealth Daytona Beach

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

  Hospital

  Care Compare affiliation
• Southeast Volusia Healthcare Corporation

  dba AdventHealth New Smyrna Beach

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1871977942
  Care Compare affiliation

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1962579086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 S RIDGEWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321322720",
            "telephone_number": "386-426-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 S RIDGEWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321322720",
            "telephone_number": "386-426-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRADET",
        "first_name": "SHELLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Fisher
• Florida Health Care Plans Inc (Florida Health Care Plan Pharmacy)
• Florida Healthy Sleep LLC
• Florida HH Services
• Florida Shores Assisted Living Facility Inc. (Florida Shores of Edgewater ALF)
• Patricia Fredette-Huffman, MD
• Evan Micheal Frobose, D.C.
• Melinda Kathleen Gamble, MS, CCC/SLP
• Patricia Gardner, CNA
• Katelynn Geib

• Physician Assistant in Edgewater, FL
• Providers in Edgewater, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.