Individual provider Active NPI

Jacob Cornman, CAA

  • Anesthesiologist Assistant
  • Tampa, FL
National Provider Identifier
1427632587
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA660 Issued in FL
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(813) 745-7365
Fax
(813) 449-8618
NPI assigned
May 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA660 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-7365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210914000300 FL Practitioner - Anesthesiology Assistant 4183020332 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Florida Anesthesiologists LLCGroup PAC ID 3173711017, 315 clinicians
H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer SCRN Ctr IncGroup PAC ID 2264337021, 1,145 clinicians
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

119 Oakfield Dr
Brandon, FL 33511-5779
Phone (954) 939-5000

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

6901 Simmons Loop
Riverview, FL 33578-9498

900 Carillon Pkwy
Suite 205
Saint Petersburg, FL 33716-1108
Phone (954) 939-5000

Hospital & facility affiliations

  • HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243
  • H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA660FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC CurrentSince Sep 8, 2021 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Nov 2, 2023 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Sep 8, 2021 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Baycare Medical Group, Inc. Current Accepting new patients

Locations

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

Interoperability endpoints

  • Direct secure messaging: jacob.cornmanaa@direct.mybaycare.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1427632587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNMAN",
        "first_name": "JACOB",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.