NPIMap

Individual provider Active NPI

Jodea A Charles, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1407579139
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116716 Issued in FL
Practice address
3301 W Gandy Blvd
Tampa, FL 33611-2931
Phone
(813) 925-1903
Fax
(813) 749-8370
NPI assigned
Sep 19, 2022
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 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 PA9116716 FL Primary

Addresses

Primary practice location

3301 W Gandy Blvd
Tampa, FL 33611-2931

Mailing address

10221 Summer Kiss Ave
Riverview, FL 33578-5851
Phone (239) 464-2147

Other identifiers 2

IdentifierTypeStateIssuer
116111200MedicaidFL
1200545OtherFLPA-C

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221108000178 FL Practitioner - Physician Assistant 3971970724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10222 Bloomingdale Ave
Riverview, FL 33578-3659
Phone (813) 515-5814

440 W Hwy 436
Adventhealth Centra Care Altamonte
Altamonte Springs, FL 32714-4136
Phone (407) 788-2000

6930 Gunn Hwy
Tampa, FL 33625-3853
Phone (813) 543-0800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Synergic Healthcare Solutions LLC CurrentSince Nov 16, 2022 Accepting new patients
Tampa General Hospital Current Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Nov 16, 2022 Accepting new patients
Synergic Healthcare Solutions LLC Current Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Nov 6, 2024 Accepting new patients
Adventist Health System/Sunbelt, Inc. Physician Assistant CurrentSince Nov 6, 2024 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

3301 W Gandy Blvd
Tampa, FL 33611
Phone (318) 925-1903

5504 Gateway Blvd
Wesley Chapel, FL 33544
Phone (813) 948-5400

16521 US 301 S
Wimauma, FL 33598
Phone (813) 844-4700

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: jcharles4124061@adventhealth.direct-ci.com
  • Direct secure messaging: jwignal254590@direct.tgh.org

Organizations & group practices 8

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 2

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": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1407579139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10221 SUMMER KISS AVE",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785851",
            "telephone_number": "239-464-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W GANDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112931",
            "telephone_number": "813-925-1903",
            "fax_number": "813-749-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "JODEA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116111200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C",
            "identifier": "1200545",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.