Evonna Ackourey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117342 Issued in FL

Practice address

1921 Waldemere St Ste 504
Sarasota, FL 34239-2941

Phone

(941) 917-8525

Fax

(941) 917-8526

NPI assigned

Oct 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, FL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• SMH Physician Services Inc

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292

  Physician Assistant

  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment
• Geisinger Clinic

  • Family Medicine Physician
  • Williamsport, PA
  • NPI 1376979534

  Physician Assistant

  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1285276139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 WALDEMERE ST STE 504",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392941",
            "telephone_number": "941-917-8525",
            "fax_number": "941-917-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKOUREY",
        "first_name": "EVONNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061187",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simona Claudia Achim, LCSW
• Lauren Ackerman, DC
• Rodes Ackerman, PHARMD
• Harold Ackerstein, MD
• Andrea Ackley, DMD
• Reynaldo Alba Acol, RPT
• Cristina Maria Acosta Diaz, MD
• Active 4 Life, PLLC
• Active Life Therapy Services
• Active Orthoticsprosthetics

• Physician Assistant in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.

Verify at the official NPI Registry.