Individual provider Active NPI

Jon-Michael Degidio

  • Anesthesiologist Assistant
  • Trinity, FL
National Provider Identifier
1144848649
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA584 Issued in FL
Practice address
9330 State Road 54
Trinity, FL 34655-1808
Phone
(727) 834-4000
NPI assigned
Jul 10, 2020
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 135-0000069 VT
Anesthesiologist Assistant 367H00000X AA584 FL Primary

Addresses

Primary practice location

9330 State Road 54
Trinity, FL 34655-1808

Mailing address

1117 17TH St N
St Petersburg, FL 33713-5719
Phone (954) 770-2837

Other practice location 1

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-2415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220818002482 VT Practitioner - Anesthesiology Assistant 0244659233 Reassigns benefits to 1 organization
I20230307001595 DC Practitioner - Anesthesiology Assistant 0244659233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA584FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Sep 25, 2020 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Sep 25, 2020 Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Feb 28, 2021 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Oct 8, 2021 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Feb 21, 2023 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Feb 21, 2023 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Jul 8, 2022 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

21298 Olean Blvd
Pt Charlotte, FL 33952
Phone (941) 624-7032

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1144848649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 17TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337135719",
            "telephone_number": "954-770-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 STATE ROAD 54",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551808",
            "telephone_number": "727-834-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-2415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGIDIO",
        "first_name": "JON-MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-10",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "VT",
            "license": "135-0000069",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.