MR. IVAN R REPASS (NPI# 1548374770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548374770 |
| Entity Type | Individual |
| Full Name | MR. IVAN R REPASS |
| Credential | PA-C |
| Practice Address |
701 Platinum Pt Lake Mary FL 32746-4871 |
| Mailing Address |
1285 Orange Ave Winter Park FL 32789-4949 |
| Practice Telephone | 4072064500 |
| Practice Fax Number | 4078292563 |
| Mailing Telephone | 4076472287 |
| Mailing Fax Number | 4076431300 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2012-03-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1668 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1668 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA1668 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
701 PLATINUM PT |
| City | LAKE MARY |
| State | FL |
| Zip Code | 32746-4871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003815812 | Michael V. Jablonski | Orthopaedic Surgery | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2005-07-14 |
| 1689174591 | Joe Louis Prince II | Physical Therapist | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2018-02-16 |
| 1093162471 | Angela Lauren Wadsworth | Physical Therapist | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2016-05-16 |
| 1467885947 | Elizabeth Nicole Yaw | Physical Therapist | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2013-08-19 |
| 1326374471 | Sarah M Colandreo | Physical Therapist | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2009-10-26 |
| 1407050404 | Luis A Gandara | Physical Medicine & Rehabilitation | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2007-06-13 |
| 1528174786 | Joseph C Tutorino | Orthopaedic Surgery | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2006-08-21 |
| 1588636997 | John M Lahr | Physician Assistant | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2006-02-02 |
| 1548257918 | Neil P. Whitwam Jr. | Nurse Practitioner | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2005-09-30 |
| 1770582405 | John R. Chase | Orthopaedic Surgery | 701 Platinum Pt, Lake Mary, FL 32746-4871 | 2005-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286397 | James Maggert | Physical Therapist | Sst Rehab, 635 Century Pt - Suite 111, Lake Mary, FL 32746 | 2020-05-14 |
| 1225663743 | Jamie Pecot | Behavior Technician | 300 International Parkway, 200, Lake Mary, FL 32746 | 2020-03-04 |
| 1619509585 | Dental Associates of Heathrow, LLC | Dentist | Dental Associates of Heathrow, LLC, 120 International Parkway Suite 26, Heathrow, FL 32746 | 2020-02-10 |
| 1376185876 | Rinehart Road Surgery Center, LLC | Clinic/Center | 392 Rinehart Road, Suite 1100, Lake Mary, FL 32746 | 2019-10-16 |
| 1871140988 | Central Florida Wellness LLC | General Practice | 1061 S Sun Drove, Suite 1041, Lake. Mary, FL 32746 | 2019-08-22 |
| 1326609942 | Antoine Slade I | Behavior Technician | 4876 Rhinehart Road, Lake Mary, FL 32746 | 2019-06-25 |
| 1245891209 | Ohri, LLC | Clinic/Center | 392 Rinehart Rd., Suite 1300, Lake Mary, FL 32746 | 2019-06-21 |
| 1336610856 | Olivia Laurel Stolz | Physician Assistant | 3300 West Lake Mary Blvd, 220, Lake Mary, FL 32746 | 2018-12-10 |
| 1881171072 | Elite-star Medical Transport LLC. | Non-emergency Medical Transport (VAN) | 2910 W Lake Mary Blvd Ste 101, Lake Mary, FL 32746 | 2018-07-20 |
| 1508351537 | Ariagny Elena Fereira | Speech-Language Pathologist | 145 Middle Street Suite 1101, Lake Mary, FL 32746 | 2018-06-22 |
| Find all providers in zip 32746 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598300238 | Trina Renee Seerup | Physician Assistant | 177 Pine St, Lake Mary, FL 32746-3502 | 2019-11-15 |
| 1356991848 | Tiffany Dyann Jones | Physician Assistant | 430 Waymont Court, Suite 100, Lake Mary, FL 32746-3503 | 2019-09-17 |
| 1124031885 | James R Piotrowski | Physician Assistant | 1315 S International Pkwy Ste 1111, Lake Mary, FL 32746-1407 | 2006-08-14 |
| 1104459668 | Rebekka Ayelet Feingold | Physician Assistant | 380 Rinehart Rd, Lake Mary, FL 32746-2551 | 2020-02-12 |
| 1902395486 | Catherine Lai-hsu | Physician Assistant | 710 N Sun Dr, Lake Mary, FL 32746-2507 | 2018-05-09 |
| 1710347620 | Nicholas Edward Constantino | Physician Assistant | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2016-03-04 |
| 1861863078 | Lauren Rivera | Physician Assistant | 917 Rinehart Rd, Suite 2041, Lake Mary, FL 32746-4802 | 2015-10-14 |
| 1073880449 | Abigail Delia Francisco | Physician Assistant | 1540 International Pkwy Ste 2000, Lake Mary, FL 32746-5096 | 2011-11-29 |
| 1851622617 | Linda Elliott Steward | Physician Assistant | 725 Rodel Cv, Lake Mary, FL 32746-4859 | 2010-01-19 |
| 1114195013 | Dawn Ellis | Physician Assistant | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2008-02-13 |
| Find all providers in LAKE MARY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.