Individual provider Active NPI

Jessica Cravens, PA

  • Medical Physician Assistant
  • Hollywood, FL
National Provider Identifier
1427420447
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9108913 Issued in FL
Practice address
3700 Washington St
#500
Hollywood, FL 33021-8256
Phone
(954) 989-4700
NPI assigned
Oct 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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 PA9108913 FL Primary

Addresses

Primary practice location

3700 Washington St
#500
Hollywood, FL 33021-8256

Mailing address

3700 Washington St
#500
Hollywood, FL 33021-8256
Phone (954) 989-4700

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
I20200330003245 FL Practitioner - Physician Assistant 0840629655 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince May 1, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince May 1, 2020 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Organizations & group practices 3

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": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1427420447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON ST",
            "address_2": "#500",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218256",
            "telephone_number": "954-989-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON ST",
            "address_2": "#500",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218256",
            "telephone_number": "954-989-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVENS",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.