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PA
NPI 1285812362
Clinic/Center - Urgent Care in Altamonte Springs, FL

Active since January 31, 2008CLIA 10D1085484 · Waiver
411 MAITLAND AVE STE 1002, ALTAMONTE SPRINGS, FL 32701(321) 207-0002(321) 207-2003 Get Directions Write a Review

NPPES record last updated: February 13, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PA (NPI 1285812362) is a healthcare organization registered as an urgent care in Altamonte Springs, Florida and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through November 28, 2026 and lists Seth T Johnson, President, as its authorized official.

NPPES Registry Identity

NPI1285812362
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameMAITLAND AVENUE URGENT CARE PA
Location Address411 MAITLAND AVE STE 1002Altamonte Springs, FL 32701-5448
Mailing Address411 Maitland Ave, Suite 1002Altamonte Springs, FL 32701-5448 · (321) 207-0002 · Fax (321) 207-0003
Phone(321) 207-0002
Fax(321) 207-2003
Organization SubpartNo
Authorized OfficialSeth T JohnsonPresident · (321) 207-0002
Enumeration DateJanuary 31, 2008
Last NPPES UpdateFebruary 13, 2014
✔ NPI 1285812362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
License✔ Licensed in FL · OS5330
411 MAITLAND AVE STE 1002, Altamonte Springs, FL 32701
Open in Google Maps ↗

Other Names 1

Other NamePa

Other Identifiers 2

Medicare UPINC68470FL
Medicaid051599000FL

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Seth Johnson, DO
Family Practice
NPI 1497726608
411 MAITLAND AVE SUITE 1002
Altamonte Springs, FL 32701
(321) 207-0002
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1085484

Maitland Avenue Urgent Care PA · Altamonte Springs, FL
Active · expires Nov 28, 2026
CLIA Number10D1085484
Laboratory TypePhysician Office
Certificate Effective DateNovember 29, 2024
Certificate Expiration DateNovember 28, 2026
Laboratory DirectorSeth T. Johnson
Laboratory Phone(321) 207-0002
Laboratory LocationMaitland Avenue Urgent Care PA411 Maitland Ave Ste 1002, Altamonte Springs, FL 32701
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maitland Avenue Urgent Care PA's NPI number?

The NPI number for Maitland Avenue Urgent Care PA is 1285812362. It was assigned to this organization in the NPPES registry on January 31, 2008. The provider is also known as PA.

Where is Maitland Avenue Urgent Care PA located?

Maitland Avenue Urgent Care PA is located at 411 Maitland Ave Ste 1002, Altamonte Springs, FL 32701. The listed phone number is (321) 207-0002.

What is Maitland Avenue Urgent Care PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Is Maitland Avenue Urgent Care PA enrolled in Medicare?

Yes. Maitland Avenue Urgent Care PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Maitland Avenue Urgent Care PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Maitland Avenue Urgent Care PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Maitland Avenue Urgent Care PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1085484) is associated with this NPI, valid through November 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Maitland Avenue Urgent Care PA was last updated on February 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.