{
"Npi": {
"NPI": "1881658854",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCHWARZ",
"FirstName": "MICHAEL",
"MiddleName": "A",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1601 LAMBROOK DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DELAND",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32724-7365",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "386-679-4944",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "271 CAREW STREET",
"SecondLinePracticeLocationAddress": "SURGICAL PA DEPARTMENT",
"PracticeLocationAddressCityName": "SPRINGFIELD",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "01104-2377",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "413-748-7353",
"PracticeLocationAddressFaxNumber": "413-748-7357",
"EnumerationDate": "04/14/2006",
"LastUpdateDate": "11/29/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "PA9102063",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "PA7375",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}