Jennifer Marie Wade, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9115997 Issued in FL

Practice address

4800 N Federal Hwy Ste 200
Fort Lauderdale, FL 33308-4611

Phone

(954) 688-7269

NPI assigned

Aug 16, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Florida Pediatric Associates LLC

  • Pediatrics Physician
  • St Petersburg, FL
  • NPI 1053346718

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1134477490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E PIGEON PLUM DR APT 108",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587867",
            "telephone_number": "908-565-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N FEDERAL HWY STE 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084611",
            "telephone_number": "954-688-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115997",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reza Voosoughi, MD
• VR Counseling Inc.
• W R Rosen Inc
• Nathalie Sofi Wacher, MD
• Susan Wade-Infanzon, L.C.S.W.
• Thomas Wade, M.D.
• Carol Ann Wadelam
• Perminder Wadhwa, DDS
• Wael Z Tamim M D P a
• Rajesh Waghmode

• All providers in Fort Lauderdale, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.