Jessica Renee Shiffner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9118868 Issued in FL

Practice address

12500 N Dale Mabry Hwy Ste a
Tampa, FL 33618-2809

Phone

(813) 960-7533

Fax

(813) 355-5039

NPI assigned

Jan 9, 2022

Sex

Female

Sole proprietor

Yes

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 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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group II LLCGroup PAC ID 0648631192, 407 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital Hospital, Tampa, FL, CCN 100075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299
  Medicare reassignment Care Compare group NPD
• Ohi West Medical Group II LLC

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1346519816
  Care Compare affiliation
• St. Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1881632818
  Care Compare affiliation

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

{
    "created_epoch": "1641686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1295496438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQUARE DR",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 N DALE MABRY HWY STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182809",
            "telephone_number": "813-960-7533",
            "fax_number": "813-355-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFFNER",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-09",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9118868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Shidler
• Andrea Shields, CGC
• David J. Shields, M. D.
• David James Shields, M.S., LMHC
• Terry Obrien Shields
• Shilo LLC
• Shilo LLC
• Shim Medical, LLC
• William Jungho Shim, M.D.
• Cindy Shimamoto

• Medical Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.