Individual provider Active NPI

Jessica Matias-Hernandez

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1265831903
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9182207 Issued in FL
Practice address
1408 N West Shore Blvd Ste 260
Tampa, FL 33607-4590
Phone
(813) 607-2630
NPI assigned
Aug 19, 2014
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9182207 FL Primary

Addresses

Primary practice location

1408 N West Shore Blvd Ste 260
Tampa, FL 33607-4590

Mailing address

17855 Dallas Pkwy Ste a
Dallas, TX 75287-6852

Other practice location 1

508 N Alexander St
Plant City, FL 33563-3036
Phone (813) 759-6607

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
I20141023000051 FL Practitioner - Nurse Practitioner 2961623509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seasons Medical Group of Florida PAGroup PAC ID 0941451314, 44 clinicians

Practice addresses (Care Compare)

1408 N W Shore Blvd
Suite 260
Tampa, FL 33607-4590
Phone (813) 607-2630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.26 of 100Reported as group
Quality
60.1
Improvement activities
40
Cost
80.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seasons Hospice & Palliative Care of Pasco County, LLC CurrentSince Oct 1, 2023 Accepting new patients
Seasons Medical Group of Florida PA CurrentSince Oct 1, 2023 Accepting new patients
West Central Gastroenterology LLP PastSince Sep 1, 2014 Accepting new patients
Healthpoint Medical Group Inc Past Accepting new patients
Seasons Hospice & Palliative Care of Tampa, LLC PastSince Oct 1, 2023 Accepting new patients

Locations

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

1408 N West Shore Blvd
Ste 260
Tampa, FL 33607
Phone (813) 607-2630

2644 Cypress Ridge Blvd
Ste 104
Wesley Chapel, FL 33544
Phone (813) 364-0311

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 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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1265831903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17855 DALLAS PKWY STE A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 N WEST SHORE BLVD STE 260",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336074590",
            "telephone_number": "813-607-2630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 N Alexander St",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335633036",
            "country_code": "US",
            "telephone_number": "813-759-6607",
            "fax_number": "813-759-8997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATIAS-HERNANDEZ",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9182207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.