Individual provider Active NPI

Angelina Josephine Schwyn Traster, PA-C

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1104456425
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9112852 Issued in FL
Practice address
6775 Crosswinds Dr N
St Petersburg, FL 33710-5471
Phone
(727) 381-8006
NPI assigned
Jan 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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 9112852 FL Primary

Addresses

Primary practice location

6775 Crosswinds Dr N
St Petersburg, FL 33710-5471

Mailing address

6775 Crosswinds Dr N
St Petersburg, FL 33710-5471
Phone (727) 381-8006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9112852FLMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1579996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1104456425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6775 CROSSWINDS DR N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105471",
            "telephone_number": "727-381-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6775 CROSSWINDS DR N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105471",
            "telephone_number": "727-381-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWYN TRASTER",
        "first_name": "ANGELINA",
        "middle_name": "JOSEPHINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-26",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.