Individual provider Active NPI

Chandler Larsen Yeazitzis, PA-C

  • Physician Assistant
  • Middleburg, FL
National Provider Identifier
1245609189
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109042 Issued in FL
Practice address
1658 St Vincents Way Ste 300
Middleburg, FL 32068-8431
Phone
(904) 276-5100
Fax
(904) 276-5393
NPI assigned
Sep 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109042 FL
Physician Assistant 363A00000X PA9109042 FL Primary

Addresses

Primary practice location

1658 St Vincents Way Ste 300
Middleburg, FL 32068-8431

Mailing address

1658 St Vincents Way Ste 300
Middleburg, FL 32068-8431
Phone (904) 276-5100

Other practice location 1

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

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
I20151214002727 FL Practitioner - Physician Assistant 3779884853 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1658 St Vincent's Way
Middleburg, FL 32068-8431

1801 Barrs St
Suite 120
Jacksonville, FL 32204-4738
Phone (904) 308-2006

2300 Park Ave
Orange Park, FL 32073-5572

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
One Med Inc. PastSince Nov 18, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: chandler.yeazitzis.1@32268.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1245609189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 300",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688431",
            "telephone_number": "904-276-5100",
            "fax_number": "904-276-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 300",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688431",
            "telephone_number": "904-276-5100",
            "fax_number": "904-276-5393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Shircliff Way",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044748",
            "country_code": "US",
            "telephone_number": "904-308-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEAZITZIS",
        "first_name": "CHANDLER",
        "middle_name": "LARSEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109042",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

Verify at the official NPI Registry.