Active NPI
Marykate Jalo
- Medical Physician Assistant
- Clearwater, FL
National Provider Identifier
1235952938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 300 Pinellas St
Clearwater, FL 33756-3804 - Phone
- (727) 462-7000
- NPI assigned
- Nov 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 9119493 | FL | |
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
300 Pinellas St
Clearwater, FL 33756-3804
Mailing address
1811 Lago Vista Blvd
Palm Harbor, FL 34685-3334
Other practice location 1
8787 Bryan Dairy Rd
Largo, FL 33777-1251
Phone (727) 394-5900
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9119493 | FL | MD | Emergency Medicine Physician |
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.
-
- Emergency Medicine Physician
- Clearwater, FL
- NPI 1164459095
-
- Emergency Medicine Physician
- New Port Richey, FL
- NPI 1568771707
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730505600000",
"number": "1235952938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 LAGO VISTA BLVD",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346853334"
},
{
"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": "727-462-7000"
}
],
"practiceLocations": [
{
"address_1": "8787 Bryan Dairy Rd",
"address_purpose": "LOCATION",
"city": "Largo",
"state": "FL",
"postal_code": "337771251",
"country_code": "US",
"telephone_number": "727-394-5900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JALO",
"first_name": "MARYKATE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-02",
"last_updated": "2024-11-02",
"certification_date": "2024-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "9119493",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.