Individual provider Active NPI

Jacinta Jean Williams

  • Physician Assistant
  • Rockledge, FL
National Provider Identifier
1205602679
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1400 Rockledge Blvd
Rockledge, FL 32955-2846
Phone
(321) 735-8960
NPI assigned
Nov 28, 2023
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 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 NU Primary

Addresses

Primary practice location

1400 Rockledge Blvd
Rockledge, FL 32955-2846

Mailing address

953 Danby Rd
Ithaca, NY 14850-7000
Phone (607) 274-3011

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
I20241003002152 FL Practitioner - Physician Assistant 8820529696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

10650 SW Tradition Pkwy
Port Saint Lucie, FL 34987-2862
Phone (772) 241-6840

1150 US Hwy 1
Vero Beach, FL 32960-5769
Phone (772) 978-5679

1730 SW Saint Lucie W Blvd
Port Saint Lucie, FL 34986-2504
Phone (772) 873-8155

1801 NE Jensen Beach Blvd
(Mdnow Jensen Beach)
Jensen Beach, FL 34957-7233
Phone (772) 334-1700

1900 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5554
Phone (772) 398-1588

4007 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-5679
Phone (772) 343-1774

4570 Lantana Rd
Lake Worth, FL 33463-6908
Phone (561) 963-9881

5550 S US Hwy 1
Fort Pierce, FL 34982-8701
Phone (772) 460-9227

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Jun 2, 2025 Accepting new patients
Medfast Urgent Care Centers LLC CurrentSince Oct 1, 2024 Accepting new patients
Medfast Urgent Care Centers, LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

1838 Rye Rd
#107
Bradenton, FL 34212
Phone (941) 462-2004

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

1400 Rockledge Blvd
Rockledge, FL 32955
Phone (321) 735-8960

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1205602679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 DANBY RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148507000",
            "telephone_number": "607-274-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 ROCKLEDGE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552846",
            "telephone_number": "321-735-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACINTA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.