Individual provider Active NPI

Lynette K Jubay, PA

  • Physician Assistant
  • Largo, FL
National Provider Identifier
1316045479
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109548 Issued in FL
Practice address
11200 Seminole Blvd Ste 310
Largo, FL 33778-3239
Phone
(727) 397-8557
NPI assigned
Sep 20, 2006
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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 PA9109548 FL Primary

Addresses

Primary practice location

11200 Seminole Blvd Ste 310
Largo, FL 33778-3239

Mailing address

11200 Seminole Blvd Ste 310
Largo, FL 33778-3239
Phone (727) 397-8557

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
I20171006001758 FL Practitioner - Physician Assistant 1153423561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11200 Seminole Blvd
Suite 310
Largo, FL 33778-3239
Phone (727) 397-8557

1800 Dr Martin Luther King Jr St N
Saint Petersburg, FL 33704-4222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pediatric Associates LLC CurrentSince Mar 25, 2022 Accepting new patients
John Drygas LLC Past Accepting new patients
James a. Diienno, D.C., P.a. PastSince Feb 1, 2021 Accepting new patients
Pediatric Physician Services, Inc. Past Accepting new patients

Locations

11200 Seminole Blvd
Ste 310
Largo, FL 33778
Phone (727) 397-8557

1800 Dr Martin Luther King St N
St Petersburg, FL 33704
Phone (727) 821-2121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1316045479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 SEMINOLE BLVD STE 310",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337783239",
            "telephone_number": "727-397-8557",
            "fax_number": "727-397-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 SEMINOLE BLVD STE 310",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337783239",
            "telephone_number": "727-397-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUBAY",
        "first_name": "LYNETTE",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.