Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amber Grimm, PA-C

Individual provider Physician Assistant · NPI 1609414143

Amber Grimm, PA-C is a Physician Assistant in Lake Mary, Florida. Qualified in 2019, 7 years ago. Practices with Burgundy Prime Inc, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1337 S International Pkwy Ste 1301
Lake Mary, FL 32746-1402
Phone: (407) 878-0022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9112838 (FL)

Record details

NPI number1609414143
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedDecember 16, 2019
Last updated in NPPESJanuary 12, 2024
Certification dateJanuary 12, 2024
Mailing address1337 S International Pkwy Ste 100, Lake Mary, FL 32746-1402

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Burgundy Prime Inc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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