FAMILY CARE ON EUSTIS SQUARE PA
NPI 1659473833
Physician Assistant - Medical in Eustis, FL
About Family Care On Eustis Square Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAMILY CARE ON EUSTIS SQUARE PA (NPI 1659473833) is a healthcare organization registered as a medical in Eustis, Florida and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through September 8, 2027 and lists Keith R Hester, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Family Care On Eustis Square Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Family Care On Eustis Square PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 10D0961314
Family Care On Eustis Square PA · Eustis, 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 Family Care On Eustis Square PA's NPI number?
The NPI number for Family Care On Eustis Square PA is 1659473833. It was assigned to this organization in the NPPES registry on September 1, 2006.
Where is Family Care On Eustis Square PA located?
Family Care On Eustis Square PA is located at 1 W Park Ave, Eustis, FL 32726. The listed phone number is (352) 357-4629.
What is Family Care On Eustis Square PA's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Family Care On Eustis Square PA enrolled in Medicare?
Yes. Family Care On Eustis Square PA is registered in the Medicare PECOS enrollment system.
When is Family Care On Eustis Square PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Family Care On Eustis Square PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Family Care On Eustis Square 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 Family Care On Eustis Square PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D0961314) is associated with this NPI, valid through September 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Family Care On Eustis Square PA was last updated on July 23, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Family Care On Eustis Square Pa · NPI 1659473833
Medical organization in Eustis, Florida. Organization record, active in the CMS NPPES registry since September 1, 2006.
## Identity
- **NPI:** 1659473833 (Entity type: Organization)
- **Enumerated:** September 1, 2006
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **Organization subpart:** No
- **Authorized official:** Keith Hester, OWNER
## Practice location
- **Address:** 1 W PARK AVE, Eustis, FL 32726-2947
- **Phone:** (352) 357-4629 · **Fax:** (352) 357-9367
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 23, 2009
- **Other identifiers:** Other K0951 (FL); Medicaid 259149900 (FL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1659473833) · Data from the CMS NPPES public registry.