Individual provider Active NPI

Tiffany Byrd, PA

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1114287299
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106538 Issued in FL
Practice address
7855 Argyle Forest Blvd
Ste 701
Jacksonville, FL 32244-5596
Phone
(904) 483-2277
Fax
(904) 483-2297
NPI assigned
May 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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 PA9106538 FL Primary

Addresses

Primary practice location

7855 Argyle Forest Blvd
Ste 701
Jacksonville, FL 32244-5596

Mailing address

151 Southhall LN
Ste 300
Maitland, FL 32751-7176
Phone (407) 875-2080

Other identifiers 1

IdentifierTypeStateIssuer
1102404OtherFLNCCPA

Other names 1

  • Tiffany Williams Former name

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
I20120605000579 FL Practitioner - Physician Assistant 1759545676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leavitt Medical Associates of Florida IncGroup PAC ID 4688579311, 199 clinicians

Practice addresses (Care Compare)

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

7855 Argyle Forest Blvd
Suite 701
Jacksonville, FL 32244-7705
Phone (904) 483-2277

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Apr 29, 2012 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Apr 29, 2012 Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients

Locations

26344 US Highway 19 N
Clearwater, FL 33761
Phone (727) 669-3676

7855 Argyle Forest Blvd
Ste 701
Jacksonville, FL 32244
Phone (904) 483-2277

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1114287299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN",
            "address_2": "STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517176",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 ARGYLE FOREST BLVD",
            "address_2": "STE 701",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445596",
            "telephone_number": "904-483-2277",
            "fax_number": "904-483-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "TIFFANY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1102404",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "WILLIAMS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.