Individual provider Active NPI

Jason Descalso, PA

  • Physician Assistant
  • Celebration, FL
National Provider Identifier
1215090279
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104051 Issued in FL
Practice address
380 Celebration PL FL 3
Celebration, FL 34747-4606
Phone
(407) 303-4673
NPI assigned
Dec 19, 2006
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104051 FL Primary
Surgical Physician Assistant 363AS0400X PA9104051 FL

Addresses

Primary practice location

380 Celebration PL FL 3
Celebration, FL 34747-4606

Mailing address

380 Celebration PL FL 3
Celebration, FL 34747-4606
Phone (407) 303-4673

Other practice location 1

4215 Edgewater Dr
Orlando, FL 32804-2206
Phone (973) 826-8291

Other identifiers 2

IdentifierTypeStateIssuer
292716100MedicaidFL
HF826AOtherFLGRP PTAN QSS-SCS

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
I20070615000583 FL Practitioner - Physician Assistant 2860591815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

380 Celebration PL
FL 2
Celebration, FL 34747-4606
Phone (321) 939-3553

400 Celebration PL
Celebration, FL 34747-4970

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.39 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
55.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9104051FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Clinical Services,Inc. Surgical CurrentSince Mar 1, 2021 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Oct 9, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 9, 2023 Accepting new patients
Orlando Cancer Center Inc Past Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

4215 Edgewater Dr
Orlando, FL 32804
Phone (407) 539-2000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jdescalso129263@adventhealth.direct-ci.com

Organizations & group practices 5

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 5

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1215090279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CELEBRATION PL FL 3",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474606",
            "telephone_number": "407-303-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CELEBRATION PL FL 3",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474606",
            "telephone_number": "407-303-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4215 Edgewater Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328042206",
            "country_code": "US",
            "telephone_number": "973-826-8291",
            "fax_number": "888-972-6480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESCALSO",
        "first_name": "JASON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104051",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104051",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292716100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP PTAN QSS-SCS",
            "identifier": "HF826A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.