Individual provider Active NPI

Jesse Sutcliffe, PA-C

  • Physician Assistant
  • Greenacres, FL
National Provider Identifier
1245978469
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4387 Appian Way
Greenacres, FL 33463-4691
Phone
(561) 602-0235
NPI assigned
May 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 FL Primary

Addresses

Primary practice location

4387 Appian Way
Greenacres, FL 33463-4691

Mailing address

4387 Appian Way
Greenacres, FL 33463-4691
Phone (561) 602-0235

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
I20220907004003 FL Practitioner - Physician Assistant 1759765951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2022
Medicare assignment
May accept Medicare assignment
Group practices
The Orthopaedic Institute, PAGroup PAC ID 2860385242, 113 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

146 SW Orthopedic CT
Lake City, FL 32024-0672
Phone (386) 755-9215

1710 SE 16TH Ave
Ocala, FL 34471-4656
Phone (352) 620-1900

4500 Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 336-6000

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Institute PA CurrentSince Aug 1, 2022 Accepting new patients
The Orthopaedic Institute, PA CurrentSince Aug 1, 2022 Accepting new patients

Locations

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

146 SW Orthopedic Ct
Lake City, FL 32024
Phone (386) 755-9215

Organizations & group practices 3

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 1

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1245978469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4387 APPIAN WAY",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634691",
            "telephone_number": "561-602-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4387 APPIAN WAY",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334634691",
            "telephone_number": "561-602-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTCLIFFE",
        "first_name": "JESSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.