Individual provider Active NPI

Patricia Lynn Tucker, PA-C

  • Medical Physician Assistant
  • Jupiter, FL
National Provider Identifier
1386899250
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9101344 Issued in FL
Practice address
4600 Military TRL Ste 115
Jupiter, FL 33458-4811
Phone
(561) 776-5252
Fax
(561) 776-5255
NPI assigned
Nov 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9101344 FL Primary

Addresses

Primary practice location

4600 Military TRL Ste 115
Jupiter, FL 33458-4811

Mailing address

4600 Military TRL Ste 115
Jupiter, FL 33458-4811
Phone (561) 776-5252

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
I20131113001161 FL Practitioner - Physician Assistant 6406082825 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9101344FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jupiter Familyhealthcare,PA CurrentSince Nov 9, 2025 Accepting new patients
New Age Dermatology Inc PastSince Nov 9, 2025 Accepting new patients
Mark E Pomper MD PA Past Accepting new patients

Locations

4600 Military Trl
Ste 115
Jupiter, FL 33458
Phone (561) 775-5252

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDDIBA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1386899250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL STE 115",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584811",
            "telephone_number": "561-776-5252",
            "fax_number": "561-776-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRL STE 115",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584811",
            "telephone_number": "561-776-5252",
            "fax_number": "561-776-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9101344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.