| Mr Benjamin Michael Ensell, PA-C | |
|
5821 S Williamson Blvd Ste 202, Port Orange, FL 32128-6102 | |
| (386) 231-6325 | |
| Not Available |
| Full Name | Mr Benjamin Michael Ensell |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 13 Years |
| Location | 5821 S Williamson Blvd Ste 202, Port Orange, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932540861 | NPI | - | NPPES |
| PA9107261 | Other | FL | PHYSICIAN ASSISTANT LICENSE |
| W6014 | Other | FL | HFMG |
| 015492900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9107261 (Florida) | Primary |
| 363AM0700X | Physician Assistant - Medical | PA9107261 (Florida) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventhealth Daytona Beach | Daytona beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Health First Privia Medical Group | 3173965993 | 247 |
| Entity Name | Baycare Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043269871 PECOS PAC ID: 6406753623 Enrollment ID: O20031216000718 |
| Entity Name | Health First Privia Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700649043 PECOS PAC ID: 3173965993 Enrollment ID: O20240524002147 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Benjamin Michael Ensell, PA-C 5821 S Williamson Blvd Ste 202, Port Orange, FL 32128-6102 Ph: (386) 231-6325 | Mr Benjamin Michael Ensell, PA-C 5821 S Williamson Blvd Ste 202, Port Orange, FL 32128-6102 Ph: (386) 231-6325 |
Keri Long Miller, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1165 Dunlawton Ave Ste 105, Port Orange, FL 32127 Phone: 386-425-4787 Fax: 386-425-4788 |
Mr. Matthew John Morrison, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1690 Dunlawton Ave Ste 210, Port Orange, FL 32127 Phone: 386-763-4920 Fax: 386-763-4939 |
Pamela Ross, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 802 Dunlawton Ave, Institute For Wellbeing Suite 102, Port Orange, FL 32127 Phone: 386-763-2338 |
Zachary King Roberts, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1208 Dunlawton Ave, Port Orange, FL 32127 Phone: 386-304-7320 |
Katie Weisz Cremata, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3635 Clyde Morris Blvd Ste 100, Port Orange, FL 32129 Phone: 386-788-7842 Fax: 386-756-8802 |
Sidney Celine Moore, PHYSICIAN ASSISTANT Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 1728 Dunlawton Ave Ste 5, Port Orange, FL 32127 Phone: 386-304-3404 |
Mrs. Joanna Elizabeth Stoverink, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3635 S Clyde Morris Blvd, Ste 100, Port Orange, FL 32129 Phone: 386-788-1242 Fax: 386-756-8802 |