Individual provider Active NPI

Nathan Vermont Shortridge Jr., CAA

  • Anesthesiologist Assistant
  • Palm Beach Gardens, FL
National Provider Identifier
1447124573
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA1163 Issued in FL
Practice address
3360 Burns Rd
Palm Beach Gardens, FL 33410-4323
Phone
(561) 622-1411
NPI assigned
Oct 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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 AA1163 FL Primary

Addresses

Primary practice location

3360 Burns Rd
Palm Beach Gardens, FL 33410-4323

Mailing address

3360 Burns Rd
Palm Beach Gardens, FL 33410-4323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251017002525 FL Practitioner - Anesthesiology Assistant 9739676198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PBG Team Anesthesia PAGroup PAC ID 5092856757, 46 clinicians

Practice addresses (Care Compare)

3360 Burns Rd
Palm Beach Gardens, FL 33410-4323
Phone (800) 694-7225

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AA1163FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PBG Team Anesthesia PA CurrentSince Nov 1, 2025 Accepting new patients

Locations

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

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 and National Provider Directory roles.

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": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1447124573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 BURNS RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 BURNS RD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104323",
            "telephone_number": "561-622-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTRIDGE",
        "first_name": "NATHAN",
        "middle_name": "VERMONT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA1163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.