Individual provider Active NPI

Rachael L Suddarth, PA

  • Surgical Physician Assistant
  • Safety Harbor, FL
National Provider Identifier
1447483466
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9105226 Issued in FL
Practice address
1840 Mease Dr Ste 404
Safety Harbor, FL 34695-6606
Phone
(727) 712-0980
Fax
(813) 635-2694
NPI assigned
Aug 25, 2009
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9105226 FL Primary

Addresses

Primary practice location

1840 Mease Dr Ste 404
Safety Harbor, FL 34695-6606

Mailing address

1840 Mease Dr Ste 404
Safety Harbor, FL 34695-6606
Phone (727) 712-0980

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Rachel.SuddarthPAC@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100111000607 FL Practitioner - Physician Assistant 1456492586 Reassigns benefits to 2 organizations
I20190116001861 IL Practitioner - Physician Assistant 1456492586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians

Practice addresses (Care Compare)

1700 S Tamiami Trail
FPG Central Billing Office
Sarasota, FL 34239-3509

1700 S Tamiami TRL
Sarasota, FL 34239-3509
Phone (941) 917-7760

1921 Waldemere St
Sarasota, FL 34239-2941

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Physician Assistant CurrentSince Oct 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2019 Accepting new patients
SMH Physician Services Inc Physician Assistant CurrentSince Jul 24, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2019 Accepting new patients
SMH Physician Services Inc Past Accepting new patients

Locations

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

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 281-9390

455 Pinellas St
Ste 320
Clearwater, FL 33756
Phone (727) 443-6798

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

1840 Mease Dr
Ste 404
Safety Harbor, FL 34695
Phone (727) 712-0980

1540 S Tamiami Trl
Ste 303
Sarasota, FL 34239
Phone (941) 371-9710

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

Dept 5777
Carol Stream, IL 60122

251 E Huron St
#16
Chicago, IL 60611

675 N Saint Clair St
Ste 19-100
Chicago, IL 60611
Phone (312) 664-3278

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rachael.suddarthpac@direct.mybaycare.org
  • Direct secure messaging: rachel.suddarthpac@direct.mybaycare.org

Organizations & group practices 5

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 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": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1447483466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 MEASE DR STE 404",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956606",
            "telephone_number": "727-712-0980",
            "fax_number": "813-635-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MEASE DR STE 404",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956606",
            "telephone_number": "727-712-0980",
            "fax_number": "813-635-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDARTH",
        "first_name": "RACHAEL",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9105226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rachel.SuddarthPAC@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

Verify at the official NPI Registry.