Individual provider Active NPI

Megan Dela Rea

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1154942571
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9116141 Issued in FL
Practice address
11545 Petersham Falls LN
Jacksonville, FL 32258-2514
Phone
(904) 993-7504
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X PA9116141 FL Primary

Addresses

Primary practice location

11545 Petersham Falls LN
Jacksonville, FL 32258-2514

Mailing address

11545 Petersham Falls LN
Jacksonville, FL 32258-2514
Phone (904) 993-7504

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
I20230418002498 FL Practitioner - Physician Assistant 5890160121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Janovitz Parrillo Delgado and Shah MD PAGroup PAC ID 1456357664, 12 clinicians

Practice addresses (Care Compare)

2859 Delaney Ave
Orlando, FL 32806-5412
Phone (407) 843-1620

2863 Delaney Ave
Orlando, FL 32806-5412
Phone (407) 843-1620

2863 S Delaney Ave
Orlando, FL 32806-5412

National Provider Directory

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

Organizations & group practices 2

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": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1154942571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545 PETERSHAM FALLS LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582514",
            "telephone_number": "904-993-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11545 PETERSHAM FALLS LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582514",
            "telephone_number": "904-993-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA REA",
        "first_name": "MEGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9116141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.