Active NPI
Jenna Nicole Caputo, PA-C
- Physician Assistant
- Brandon, FL
National Provider Identifier
1053109272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9120130
- Practice address
- 500 Vonderburg Dr Ste 115W
Brandon, FL 33511-5969 - Phone
- (813) 535-6212
- NPI assigned
- Apr 28, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9120130 | FL | Primary |
Addresses
Primary practice location
500 Vonderburg Dr Ste 115W
Brandon, FL 33511-5969
Mailing address
6169 30TH Ave N
St Petersburg, FL 33710-3335
Phone (727) 946-7795
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4651 Van Dyke Rd
Lutz, FL 33558-4880
Phone (813) 321-1786
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9120130 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Douglas K Pierce MD PA | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dermatology Physician
- Lutz, FL
- NPI 1487827416
-
dba The Dermatology Clinic
- Procedural Dermatology Physician
- Largo, FL
- NPI 1053515379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746057600000",
"number": "1053109272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6169 30TH AVE N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337103335",
"telephone_number": "727-946-7795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 VONDERBURG DR STE 115W",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115969",
"telephone_number": "813-535-6212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPUTO",
"first_name": "JENNA",
"middle_name": "NICOLE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-28",
"last_updated": "2025-05-01",
"certification_date": "2025-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9120130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.