Individual provider Active NPI

Jared Siminski, PA-C

  • Physician Assistant
  • Clearwater, FL
National Provider Identifier
1144088972
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118526 Issued in FL
Practice address
300 Pinellas St
Clearwater, FL 33756-3804
Phone
(727) 298-6612
Fax
(727) 461-8085
NPI assigned
Mar 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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 PA9118526 FL Primary

Addresses

Primary practice location

300 Pinellas St
Clearwater, FL 33756-3804

Mailing address

2922 Cypress RDG
Palm Harbor, FL 34684-4910
Phone (727) 410-1536

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
I20240501001216 FL Practitioner - Physician Assistant 5597105072 Reassigns benefits to 1 organization

National Provider Directory

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1144088972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 CYPRESS RDG",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346844910",
            "telephone_number": "727-410-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-298-6612",
            "fax_number": "727-461-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMINSKI",
        "first_name": "JARED",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.