Individual provider Active NPI

Daniel Le Phan

  • Anesthesiologist Assistant
  • Jacksonville, FL
National Provider Identifier
1992327308
Registry record updated Oct 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
589 Issued in FL
Practice address
800 Prudential Dr FL 32207
Jacksonville, FL 32207-8202
Phone
(904) 202-2000
NPI assigned
May 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 589 FL Primary

Addresses

Primary practice location

800 Prudential Dr FL 32207
Jacksonville, FL 32207-8202

Mailing address

2220 Tall Grass Ave
Bartow, FL 33830-2945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006001603 FL Practitioner - Anesthesiology Assistant 7012336373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 202-2000

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
589FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Anesthesiologist Assistant CurrentSince Sep 22, 2020 Accepting new patients

Locations

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

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 2

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": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601769600000",
    "number": "1992327308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 TALL GRASS AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338302945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR FL 32207",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-202-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "DANIEL",
        "middle_name": "LE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-08",
        "last_updated": "2020-10-04",
        "certification_date": "2020-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.