SAMUEL GORDON HATHCOCK PA
NPI 1992375554
Physician Assistant in Celebration, FL

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363A00000X.

Active since June 28, 2021PECOS EnrolledAccepts Medicare Assignment

410 CELEBRATION PL STE 300, CELEBRATION, FL 34747(407) 894-4474(407) 894-7032 Get Directions Write a Review

NPPES record last updated: January 16, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 28, 2022, Oct 7, 2021, Jun 28, 2021 (3 updates tracked since 2021).

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About Samuel Gordon Hathcock Pa NPPES

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

SAMUEL GORDON HATHCOCK PA (NPI 1992375554) is an individual physician assistant in Celebration, Florida, licensed in Florida (PA9116218) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and maintains a secondary practice location in Gainesville.

NPPES Registry Identity

NPI1992375554

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameSAMUEL GORDON HATHCOCKCredential: PA

Location Address410 CELEBRATION PL STE 300Celebration, FL 34747-5434

Mailing Address4645 Nw 8th AveGainesville, FL 32605-4687 · (352) 375-1212 · Fax (352) 371-4650

Phone(407) 894-4474

Fax(407) 894-7032

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJune 28, 2021

Last NPPES UpdateJanuary 16, 20243 updates tracked since enumeration

NPPES CertifiedJanuary 16, 2024

✔ NPI 1992375554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in FL · PA9116218✔ Licensed in VA · 0110-008149

Definition

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.

410 CELEBRATION PL STE 300, Celebration, FL 34747

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Secondary Practice Location 1

Location 14645 NW 8th AveGainesville, FL 32605-4687 · Phone (352) 375-1212 · Fax (352) 371-4650

Other Identifiers 1

Other0110-008149VA · Virginia Board Of Medicine License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samuel Gordon Hathcock Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345639118

PECOS Enrollment IDI20221109003022

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

71 services70 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

69 services49 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

34 services34 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

22 services21 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

17 services17 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100007

Location601 E Rollins StOrlando, FL 32803 · Orange County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34747 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADVANCED ALLERGY & ASTHMA SPECIALIST

Allergy & Immunology