Individual provider Active NPI

Jenissa Denee Leite Da Silva, PA-C

  • Physician Assistant
  • Palm Coast, FL
National Provider Identifier
1023615507
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113699 Issued in FL
Practice address
61 Memorial Medical Pkwy Ste 2811
Palm Coast, FL 32164-5999
Phone
(386) 586-1955
Fax
(386) 586-1959
NPI assigned
Oct 7, 2020
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113699 FL Primary

Addresses

Primary practice location

61 Memorial Medical Pkwy Ste 2811
Palm Coast, FL 32164-5999

Mailing address

PO Box 935921
Atlanta, GA 31193-5921

Other practice location 1

11600 Lakeside Village Ln
Windermere, FL 34786-7024
Phone (407) 876-2273

Other practice location 2

12301 Lake Underhill Rd Ste 215
Orlando, FL 32828-4511
Phone (321) 235-0692

Other identifiers 1

IdentifierTypeStateIssuer
OE838OtherFLMEDICARE HF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210107000435 FL Practitioner - Physician Assistant 2860805033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

61 Memorial Medical Pkwy
Palm Coast, FL 32164-5982

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9113699FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Flagler Inc. CurrentSince Apr 30, 2024 Accepting new patients
Memorial Hospital Flagler Inc CurrentSince Apr 30, 2024 Accepting new patients
Adventhealth Primary Care Network Inc Medical Past Accepting new patients

Locations

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

120 Cypress Edge Dr
Ste 210
Palm Coast, FL 32164
Phone (386) 445-4750

61 Memorial Medical Pkwy
Ste 2811
Palm Coast, FL 32164
Phone (386) 586-1955

120 Cypress Edge Dr
Ste 102
Palm Coast, FL 32164
Phone (386) 586-4280

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jleitedasilva1228331@adventhealth.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1023615507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935921",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY STE 2811",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645999",
            "telephone_number": "386-586-1955",
            "fax_number": "386-586-1959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 Lakeside Village Ln",
            "address_purpose": "LOCATION",
            "city": "Windermere",
            "state": "FL",
            "postal_code": "347867024",
            "country_code": "US",
            "telephone_number": "407-876-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12301 Lake Underhill Rd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328284511",
            "country_code": "US",
            "telephone_number": "321-235-0692",
            "fax_number": "321-235-0694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEITE DA SILVA",
        "first_name": "JENISSA",
        "middle_name": "DENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "OE838",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.