Laura Prevatt, PA-C
Individual provider Active NPI Physician Assistant · Celebration, FL
NPI 1992579817 · NPPES record last updated Mar 21, 2024
Key facts
- NPI
- 1992579817
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9118199 (FL)
- Practice address
- 1530 Celebration Blvd Ste 101
Celebration, FL 34747-5165 - Phone
- (407) 566-0404
- NPI assigned
- Nov 10, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Adventhealth Primary Care Network Inc
Practice addresses (Care Compare)
1530 Celebration Blvd
Suite 101
Celebration, FL 34747-5165
Phone (407) 566-0404
661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040
Hospital & facility affiliations
- Adventhealth Home Health
- Adventhealth Orlando
- Adventhealth Heart of Florida
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240115001042 | FL | Practitioner - Physician Assistant | 0345692406 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Interoperability endpoints
- lprevatt893735@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9118199 | FL | Yes |
| Family Medicine Physician | 207Q00000X | PA9118199 | FL |
Addresses
Primary practice location
1530 Celebration Blvd Ste 101
Celebration, FL 34747-5165
Mailing address
5032 Millenia Palms Dr Apt 5301
Orlando, FL 32839-2372
Phone (813) 404-2138
NPI Registry JSON
{
"created_epoch": "1699574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1992579817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5032 MILLENIA PALMS DR APT 5301",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328392372",
"telephone_number": "813-404-2138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 CELEBRATION BLVD STE 101",
"city": "CELEBRATION",
"state": "FL",
"postal_code": "347475165",
"telephone_number": "407-566-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREVATT",
"first_name": "LAURA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-10",
"last_updated": "2024-03-21",
"certification_date": "2024-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9118199",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "PA9118199",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Celebration, FL
- Michael P Potts
- Elizabeth Powell
- Preferred Care at Home
- Premise Health of Florida Medical PA
- India Chantel Presley-Boyd
- Rebecca Rogers Prevost
- Proact Health Solutions Inc
- Psychology of Original Love Counseling, LLC.
- Alyssa Ptacek
- Publix Super Markets Inc
All providers in Celebration, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.