CRAIG DAVID QUEZADA (PA-C) – Medical Physician Assistant, NPI 1780451492

CRAIG DAVID QUEZADA (PA-C) is a healthcare provider. based in Coral gables, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 9118229 (FL). The NPI Number for CRAIG DAVID QUEZADA (PA-C) is 1780451492

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
CRAIG DAVID QUEZADA (PA-C)
NPI
1780451492
Phone
(757) 750-5458
Address
2521 SAN DOMINGO ST
Enumeration Date
4 December 2023
Last Update Date
6 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8302858882
Graduation Year
2023 (3 years ago)
PAC ID
0244681195
Group Practice PAC ID
9537547617
Professional Enrollment ID
I20250314002055
Address ID
WA980924841AU32104SEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

9,232 PHYSICIAN ASSISTANT in FL

Provider Addresses for CRAIG DAVID QUEZADA (PA-C)

  • 2521 SAN DOMINGO ST

    CORAL GABLES, FL 331345560

    Phone: (757) 750-5458

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240104004636IPhysician AssistantFLTBD
I20241205002286IPhysician AssistantCATBD
I20250314002055IPhysician AssistantWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33134)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537547617View full group profile
NameSpecialtyState
Physician AssistantWA
Nurse PractitionerIN
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

What unique ID ties claims to CRAIG DAVID QUEZADA (PA-C)?
NPI 1780451492 is assigned to CRAIG DAVID QUEZADA (PA-C) under the national enumeration system.
Is CRAIG DAVID QUEZADA (PA-C)'s NPI currently valid?
The extract we use shows CRAIG DAVID QUEZADA (PA-C) as active.
Can you summarize CRAIG DAVID QUEZADA (PA-C)'s specialty in plain language?
Clinically, the directory lists CRAIG DAVID QUEZADA (PA-C) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What location shows for CRAIG DAVID QUEZADA (PA-C)?
We surface Coral Gables, Florida for CRAIG DAVID QUEZADA (PA-C) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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