Individual provider Active NPI

Jasmine Agabin Corpuz, PA-C

  • Physician Assistant
  • Foley, AL
National Provider Identifier
1063244564
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121716 Issued in FL
Practice address
222 S Alston St
Foley, AL 36535-1914
Phone
(850) 633-4877
NPI assigned
Aug 14, 2024
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 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 PA9121716 FL Primary

Addresses

Primary practice location

222 S Alston St
Foley, AL 36535-1914

Mailing address

222 S Alston St
Foley, AL 36535-1914
Phone (850) 633-4877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260602000951 FL Practitioner - Physician Assistant 5698246502 Reassigns benefits to 1 organization
I20260609001343 AL Practitioner - Physician Assistant 5698246502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

222 S Alston St
Foley, AL 36535-1914

547 N Monroe St
Tallahassee, FL 32301-0619

PO Box
Suite 43
Swartswood, NJ 07877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9121716FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Spine & Pain PLLC CurrentSince Apr 26, 2026 Accepting new patients

Locations

222 S Alston St
Foley, AL 36535
Phone (850) 633-4877

547 N Monroe St
Tallahassee, FL 32301
Phone (201) 218-5172

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1063244564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S ALSTON ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365351914",
            "telephone_number": "850-633-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S ALSTON ST",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365351914",
            "telephone_number": "850-633-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPUZ",
        "first_name": "JASMINE",
        "middle_name": "AGABIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.