Individual provider Active NPI

Dana Tate-Solomon, PA-C

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1992770424
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101341 Issued in FL
Practice address
5449 S Semoran Blvd
Suite 14
Orlando, FL 32822-1722
Phone
(407) 322-8645
Fax
(407) 322-8725
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9101341 FL Primary

Addresses

Primary practice location

5449 S Semoran Blvd
Suite 14
Orlando, FL 32822-1722

Mailing address

2400 State Road 415
Suite 14
Sanford, FL 32771-6012
Phone (407) 322-8645

Other identifiers 3

IdentifierTypeStateIssuer
682190100MedicaidFL
01115657OtherFLAMERIGROUP
206129OtherFLWELLCARE

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
I20060503000664 FL Practitioner - Physician Assistant 9537179692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Florida Family Health Center, IncGroup PAC ID 3870519234, 17 clinicians

Practice addresses (Care Compare)

4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone 40732286452011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9101341FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Family Health Center Inc CurrentSince Oct 18, 2005 Accepting new patients
Central Florida Family Health Center Inc. CurrentSince Oct 18, 2005 Accepting new patients
Central Florida Family Health Center, Inc. Past Accepting new patients

Locations

1120 State Road 436
Ste 1200
Casselberry, FL 32707
Phone (407) 678-8000

5449 S Semoran Blvd
Ste 14
Orlando, FL 32822
Phone (407) 367-0923

2400 County Road 415A
Sanford, FL 32771

4930 E Lake Mary Blvd
Sanford, FL 32771

Organizations & group practices 4

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1992770424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 STATE ROAD 415",
            "address_2": "SUITE 14",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327716012",
            "telephone_number": "407-322-8645",
            "fax_number": "407-330-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5449 S SEMORAN BLVD",
            "address_2": "SUITE 14",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221722",
            "telephone_number": "407-322-8645",
            "fax_number": "407-322-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE-SOLOMON",
        "first_name": "DANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682190100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01115657",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "206129",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.