Individual provider Active NPI

Joshua Dillon, PA-C

  • Physician Assistant
  • Bradenton, FL
National Provider Identifier
1992431670
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117436 Issued in FL
Practice address
2020 59TH St W
Bradenton, FL 34209-4604
Phone
(941) 365-2600
NPI assigned
Jul 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9117436 FL Primary
Physical Therapy Assistant 225200000X

Addresses

Primary practice location

2020 59TH St W
Bradenton, FL 34209-4604

Mailing address

171 Golden Gate PT Apt 6
Sarasota, FL 34236-6650
Phone (941) 210-8945

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
I20240703002861 FL Practitioner - Physician Assistant 8729522503 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9117436FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Two Rivers Urgent Care and Wellness Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joshua.dillon.1@23341.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23341/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1992431670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GOLDEN GATE PT APT 6",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342366650",
            "telephone_number": "941-210-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094604",
            "telephone_number": "941-365-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "JOSHUA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-26",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117436",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.