Active NPI 1932208006 Individual Practitioner Female Practitioner

Dr. Amy Elise Witt , MD

Dermatology • Maitland, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Amy Witt, MD is a certified Dermatology practicing in Maitland, FL. With approximately 22 years of clinical experience since completing medical education in 2004, Dr. Witt delivers high-quality medical care to the local community at 800 N MAITLAND AVE.

Dr. Witt is affiliated with Derrow Dermatology Associates Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, destruction of precancer skin growth, 2-14 growths, destruction of up to 14 skin growths. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

800 N Maitland Ave
Suite 202

Maitland, FL 327514427

Telephone 4073892020

Fax 4073892021

Associated Practice Facility / Clinic

🏢 Physician Associates Llc Facility NPI 1477710697

Medicare Profile & Education

Medical School

Other

Graduation Year

2004

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Maitland, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

22 Yrs -2.3 yrs vs City Avg

City Avg: 24.3 Yrs

State Avg: 23.7 Yrs

Regional Practice Density

12 Specialists

Practicing in Maitland, FL (1273 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

64.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Witt (22 Years) 22 Yrs

Maitland Specialty Average (24.3 Years) 24.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,373	1,016	$223.75	$91.14
17003 Destruction of precancer skin growth, 2-14 growths	530	113	$15.84	$6.47
17110 Destruction of up to 14 skin growths	436	332	$274.11	$105.88
17000 Destruction of skin growth	235	187	$165.02	$50.13
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	154	154	$276.14	$112.33
11102 Tangential biopsy of single skin lesion	149	134	$242.04	$84.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	97	88	$138.73	$56.58
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	44	37	$241.67	$76.06
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	44	42	$315.61	$128.67
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	40	37	$435.38	$168.87
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	40	35	$737.26	$301.24
11103 Biopsy of related skin growth, each additional growth	34	25	$121.60	$49.66
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	32	31	$293.65	$110.20
17111 Destruction of skin growth, 15 or more growths	27	21	$321.76	$131.60
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	25	24	$279.45	$106.82
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	24	21	$361.02	$129.08
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	17	$594.43	$121.49
99202 New patient office or other outpatient visit, typically 20 minutes	19	19	$177.75	$72.28
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	16	14	$330.66	$130.49
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	15	14	$683.07	$139.49
69100 Biopsy of ear	13	12	$231.62	$72.47
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	13	11	$814.96	$319.45
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	11	11	$406.80	$151.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,123	843	$224.13	$89.90
17003 Destruction of precancer skin growth, 2-14 growths	429	78	$16.10	$6.34
17110 Destruction of up to 14 skin growths	311	237	$277.87	$108.27
17000 Destruction of skin growth	172	134	$165.54	$52.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	104	104	$280.35	$112.23
11102 Tangential biopsy of single skin lesion	75	71	$249.12	$85.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	73	67	$139.86	$56.10
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	41	36	$751.98	$297.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	29	$317.13	$127.31
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	23	22	$300.86	$118.13
11103 Biopsy of related skin growth, each additional growth	22	17	$123.90	$49.68
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	19	$606.14	$121.66
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	18	17	$287.54	$102.58
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	17	17	$248.98	$76.32
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	15	$364.42	$132.57
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	15	13	$338.33	$126.75
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	14	$442.93	$165.75
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	13	$696.03	$139.54
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	13	11	$446.41	$158.63
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	12	11	$666.20	$133.55
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	11	11	$303.85	$116.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	944	711	$227.25	$90.76
17003 Destruction of precancer skin growth, 2-14 growths	377	84	$16.45	$6.59
17110 Destruction of up to 14 skin growths	335	263	$280.90	$107.39
17000 Destruction of skin growth	154	120	$167.88	$47.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	119	119	$283.00	$113.11
11102 Tangential biopsy of single skin lesion	66	63	$254.28	$86.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	55	$141.55	$56.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	31	$319.93	$127.99
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	35	34	$758.48	$294.58
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	29	24	$305.95	$109.60
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	20	18	$446.45	$165.33
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	20	20	$254.75	$76.34
11103 Biopsy of related skin growth, each additional growth	19	15	$127.20	$50.71
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	18	18	$612.50	$122.34
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	18	16	$291.60	$103.46
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	15	$366.98	$122.36
17111 Destruction of skin growth, 15 or more growths	15	12	$329.50	$123.18
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	15	11	$344.43	$124.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	868	666	$228.38	$92.26
17003 Destruction of precancer skin growth, 2-14 growths	335	80	$15.82	$6.39
17110 Destruction of up to 14 skin growths	303	241	$279.15	$109.64
17000 Destruction of skin growth	160	134	$163.62	$51.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	115	115	$282.21	$113.70
11102 Tangential biopsy of single skin lesion	87	76	$255.63	$87.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	66	58	$139.44	$56.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	52	47	$324.33	$131.13
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	44	42	$767.38	$307.32
11103 Biopsy of related skin growth, each additional growth	24	16	$130.72	$52.99
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	23	22	$308.48	$111.25
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	22	21	$368.43	$132.38
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	21	$619.24	$125.36
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	16	$678.46	$137.56
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	14	$443.55	$169.25
17111 Destruction of skin growth, 15 or more growths	15	11	$328.50	$132.99
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	14	14	$253.55	$80.50
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	13	$705.45	$143.01
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	12	12	$310.43	$120.62
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	12	12	$792.47	$321.17
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	11	11	$294.03	$108.23

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	575	486	$187.84	$75.76
17003 Destruction of precancer skin growth, 2-14 growths	291	77	$14.69	$5.93
17110 Destruction of up to 14 skin growths	218	172	$277.07	$109.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	209	195	$272.64	$110.27
17000 Destruction of skin growth	146	122	$163.19	$55.02
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	104	92	$113.53	$45.77
11102 Tangential biopsy of single skin lesion	89	81	$248.68	$89.67
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	63	63	$270.49	$109.15
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	34	33	$755.82	$295.52
99201 New patient office or other outpatient visit, typically 10 minutes	32	32	$114.36	$46.12
11103 Biopsy of related skin growth, each additional growth	27	18	$132.64	$53.69
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	23	23	$302.23	$116.45
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	17	17	$362.53	$137.46
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	16	$620.00	$124.95
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	11	$441.36	$154.09
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	14	$681.18	$146.40
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	13	$708.67	$142.91
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	11	11	$287.86	$116.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	724	592	$178.47	$73.92
17003 Destruction of precancer skin growth, 2-14 growths	411	87	$16.22	$5.67
17110 Destruction of up to 14 skin growths	286	242	$263.50	$106.31
17000 Destruction of skin growth	193	163	$154.13	$52.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	167	153	$257.80	$108.53
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	137	119	$104.86	$44.78
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	104	104	$261.19	$108.65
11102 Tangential biopsy of single skin lesion	102	93	$237.22	$84.12
99201 New patient office or other outpatient visit, typically 10 minutes	81	81	$110.21	$45.61
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	41	41	$731.43	$301.31
99202 New patient office or other outpatient visit, typically 20 minutes	39	39	$177.57	$76.19
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	34	27	$426.77	$158.89
11103 Biopsy of related skin growth, each additional growth	27	13	$130.52	$52.91
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	22	21	$240.94	$79.14
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	21	21	$349.17	$131.02
17111 Destruction of skin growth, 15 or more growths	20	15	$300.31	$130.22
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	17	17	$609.49	$124.87
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	17	16	$261.75	$103.25
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	17	16	$296.38	$115.88
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	15	14	$656.10	$143.23
11900 Injection into skin growth, 1-7 growths	13	12	$125.55	$50.27

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	723	585	$135.67	$70.33
17003 Destruction of precancer skin growth, 2-14 growths	543	112	$19.68	$5.05
17110 Destruction of up to 14 skin growths	316	268	$197.97	$103.14
17000 Destruction of skin growth	218	180	$125.28	$47.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	165	157	$200.46	$103.91
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	158	139	$77.82	$42.17
11100 Biopsy of single growth of skin and/or tissue	150	131	$191.94	$88.19
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	114	114	$204.75	$105.03
99201 New patient office or other outpatient visit, typically 10 minutes	81	81	$88.70	$43.05
99202 New patient office or other outpatient visit, typically 20 minutes	52	52	$142.50	$72.40
11101 Biopsy of each additional growth of skin and/or tissue	45	32	$60.18	$32.01
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	40	37	$520.63	$288.08
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	35	29	$230.00	$115.49
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	34	28	$292.06	$160.07
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	33	28	$217.45	$101.50
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	28	26	$183.38	$80.43
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	26	25	$516.92	$124.86
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	18	18	$462.22	$131.85
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	16	16	$518.75	$285.82
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	13	13	$210.38	$105.40
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	11	11	$390.45	$138.35
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	11	11	$245.45	$136.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	647	544	$95.14	$72.01
17003 Destruction of precancer skin growth, 2-14 growths	452	99	$20.00	$5.49
17110 Destruction of up to 14 skin growths	256	215	$145.00	$105.56
17000 Destruction of skin growth	183	156	$105.00	$51.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	170	150	$135.00	$105.84
11100 Biopsy of single growth of skin and/or tissue	143	126	$135.00	$89.68
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	127	108	$55.00	$42.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	82	82	$140.00	$105.69
99201 New patient office or other outpatient visit, typically 10 minutes	76	76	$75.00	$43.44
99202 New patient office or other outpatient visit, typically 20 minutes	49	49	$100.00	$73.57
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	35	34	$395.00	$282.58
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	34	28	$225.00	$160.62
11101 Biopsy of each additional growth of skin and/or tissue	31	23	$50.00	$32.85
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	21	19	$155.00	$115.94
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	21	18	$125.00	$70.97
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	19	18	$185.00	$126.40
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	18	15	$350.00	$135.11
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	17	17	$320.00	$123.06
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	16	15	$380.00	$292.33
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	13	13	$365.00	$141.20
69100 Biopsy of ear	13	12	$130.00	$88.03

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License FL ME100833

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Caqh Id

11858140

Hospital & Practice Group Affiliations

Derrow Dermatology Associates Llc

146 Orange Pl, Maitland, FL 327516531

Phone: 4073892020

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners

Kathleen Gibson , PA-C

Dermatology

NPI 1063392272

Physician Assistant (Certified)

Dr. Shelley Fox , DNP, FNP-BC

Nurse Practitioner - Family

NPI 1255603817

Doctor of Nursing Practice, Family Nurse Practitioner (Board Certified)

Laurie Fashakin , PA

Physician Assistant

NPI 1275588063

Physician Assistant

Catherine Yoo

Physician Assistant

NPI 1316831852

Annie Cabrera

Physician Assistant

NPI 1720867740

Amber Mohlman , PA-C

Physician Assistant

NPI 1871289280

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active January 12, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location January 12, 2015

Registered at 800 N MAITLAND AVE, SUITE 202, MAITLAND, FL 327514427 (Tel: 4073892020)

📍

Updated Business Mailing Address January 12, 2015

Registered at 800 N MAITLAND AVE, SUITE 202, MAITLAND, FL 327514427 (Tel: 4073892020)

👤

Provider Name / Credentials Updated January 12, 2015

Recorded as AMY WITT, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 12, 2015

Dermatology (License #ME100833 in FL)

🟢

Initial NPI Registration & Enumeration September 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1932208006

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 22, 2006

Last Update: January 12, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

800 N Maitland Ave, Suite 202

Maitland, FL 327514427

Phone: 4073892020

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.