Individual provider Active NPI

Jeremy S Ware, MMS,PA-C

  • Physician Assistant
  • Port St Lucie, FL
National Provider Identifier
1326237561
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104407 Issued in FL
Practice address
9077 S Federal Hwy
Port St Lucie, FL 34952-3405
Phone
(772) 335-4770
Fax
(772) 335-4133
NPI assigned
Oct 23, 2007
Last updated
Feb 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104407 FL
Surgical Physician Assistant 363AS0400X PA9104407 FL
Physician Assistant 363A00000X PA9104407 FL Primary

Addresses

Primary practice location

9077 S Federal Hwy
Port St Lucie, FL 34952-3405

Mailing address

9077 S Federal Hwy
Port St Lucie, FL 34952-3405
Phone (772) 335-4770

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
I20071227000209 FL Practitioner - Physician Assistant 2365532652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1151 SE Indian St
Stuart, FL 34997-5765
Phone (772) 335-4770

9077 S Federal Hwy
Port St Lucie, FL 34952-3405
Phone (772) 398-7336

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mark J Powers MD PA Florida Orthopaedic Specialists CurrentSince Nov 15, 2007 Accepting new patients

Locations

9077 S US Highway 1
Port St Lucie, FL 34952
Phone (407) 335-4770

Organizations & group practices 1

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": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1326237561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9077 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523405",
            "telephone_number": "772-335-4770",
            "fax_number": "772-335-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9077 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523405",
            "telephone_number": "772-335-4770",
            "fax_number": "772-335-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARE",
        "first_name": "JEREMY",
        "middle_name": "S",
        "credential": "MMS,PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104407",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9104407",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.