PURPOSELY EVOLVING MEDICAL CLINIC
NPI 1609582782
Clinic/Center - Primary Care in Tarpon Springs, FL
About Purposely Evolving Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PURPOSELY EVOLVING MEDICAL CLINIC (NPI 1609582782) is a healthcare organization registered as a primary care in Tarpon Springs, Florida and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through June 8, 2028 and lists Dominique Paschal, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Purposely Evolving Medical Clinic 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 Purposely Evolving Medical Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Tarpon Springs, FL 34689
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 10D2262074
Purposely Evolving · Tarpon Springs, FLFrequently 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 Purposely Evolving's NPI number?
The NPI number for Purposely Evolving is 1609582782. It was assigned to this organization in the NPPES registry on January 23, 2023. The provider is doing business as Purposely Evolving Medical Clinic.
Where is Purposely Evolving located?
Purposely Evolving is located at 1810 S Pinellas Ave Ste B, Tarpon Springs, FL 34689. The listed phone number is (727) 937-6060.
What is Purposely Evolving's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Purposely Evolving enrolled in Medicare?
Yes. Purposely Evolving is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Purposely Evolving?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Purposely Evolving. 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 Purposely Evolving hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2262074) is associated with this NPI, valid through June 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Purposely Evolving accept?
Health plans from Molina Healthcare list Purposely Evolving as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Purposely Evolving was last updated on August 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Purposely Evolving Medical Clinic · NPI 1609582782
Primary Care organization in Tarpon Springs, Florida. Organization record, active in the CMS NPPES registry since January 23, 2023.
## Identity
- **NPI:** 1609582782 (Entity type: Organization)
- **Enumerated:** January 23, 2023
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Purposely Evolving
- **Organization subpart:** No
- **Authorized official:** Dominique Paschal, OWNER
## Practice location
- **Address:** 1810 S PINELLAS AVE STE B, Tarpon Springs, FL 34689-1989
- **Phone:** (727) 937-6060 · **Fax:** (727) 937-6030
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 9, 2023
- **Other identifiers:** Other 1083178040 (FL); Other 1013086917 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1609582782) · Data from the CMS NPPES public registry.