IndividualActiveAccepts Medicare

Don Wisidagama, PA

NPI 1437628260 · Medical Physician Assistant · Lake Mary, FL

Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Provider details

NPI number: 1437628260
Entity type: Individual
Primary specialty: Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Credential: PA
Sex: Male
Sole proprietor: No
License: PA9113883 (FL)

Specialties & taxonomies

Medical Physician AssistantPrimary363AM0700XLicense PA9113883 (FL)
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers

Profile Score

Detailed profile(75/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure28% of score
7 yrs in NPPES registry
Profile completeness28% of score
100% of core fields populated
Practice footprint17% of score
2 documented practice locations
Medicare service volume (vs. specialty peers)28% of score
1,037 Medicare services, 2024 (ranked within specialty)

Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

What this provider does (Medicare)

Based on Medicare fee-for-service claims, 2024; not all care is captured.

Service (HCPCS)	Medicare services	Typical Medicare-allowed (2024)
Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213	389	$78
New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203	272	$96
Detection Test By Immunoassay Technique for Severe Acute Respiratory Syndrome Coronavirus and Influenza87428	91	$65
Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214	69	$109
New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204	51	$144
Detection Test By Immunoassay Technique for Severe Acute Respiratory Syndrome Coronavirus

What this provider prescribes (Medicare Part D)

Top drugs by Medicare Part D claim volume, 2024 · 21 distinct drugs on file.

Drug	Part D claims (2024)	Beneficiaries
Amoxicillin/Potassium Clavbrand: Amoxicillin-Clavulanate Potass	165	165
Cephalexin	124	122
Doxycycline Hyclate	69	69
Diclofenac Sodium	67	62
Methylprednisolone	54	54
Azithromycin	35	35
Albuterol Sulfatebrand: Albuterol Sulfate Hfa	35	33

Practice location

725 Rodel Cv

Lake Mary, FL 32746-4859

Phone: (407) 302-3130

Fax: (407) 302-3132

Street-level locationGet directions

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Mailing address