Active NPI
Jennifer Eden Caballero, PA-C
- Physician Assistant
- Sarasota, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 9106259
- Practice address
- 1921 Waldemere St Ste 705
Sarasota, FL 34239-2913 - Phone
- (941) 366-5864
- NPI assigned
- Oct 31, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9106259 | FL | Primary |
Addresses
Primary practice location
1921 Waldemere St Ste 705
Sarasota, FL 34239-2913
Mailing address
1921 Waldemere St Ste 705
Sarasota, FL 34239-2913
Phone (941) 366-5864
Other practice location 1
1700 S Tamiami Trl
Sarasota, FL 34239-3555
Phone (941) 917-9000
Other practice location 2
2600 Laurel Rd E
North Venice, FL 34275-3226
Phone (941) 917-9000
Other practice location 3
200 Healthcare Way Unit 102
North Venice, FL 34275-3670
Phone (941) 366-5864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016967300 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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 34239-2913
1921 Waldemere St
Sarasota, FL 34239-2941
200 Healthcare Way
North Venice, FL 34275-3670
Hospital & facility affiliations
- Sarasota Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lung Associates of Sarasota LLC | Current | Accepting new patients | |
| SMH Physician Services Inc | Physician Assistant | Current | Accepting new patients |
| Angsten Center for Pulmonary & Sleep | Past | Accepting new patients | |
| Jose R. Marquina, M.D., P.a. | Past | Accepting new patients | |
| SMH Physician Services Inc | Past | Accepting new patients |
Locations
200 Healthcare Way
Unit 102
North Venice, FL 34275
Phone (941) 366-5864
2600 Laurel Rd E
North Venice, FL 34275
Phone (941) 261-9000
1921 Waldemere St
Ste 705
Sarasota, FL 34239
Phone (941) 366-5864
1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507
1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10086560
- jennifercaballero@las.allscriptsdirect.net
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Sarasota, FL
- NPI 1346295292
Physician Assistant
-
- Pulmonary Disease Physician
- Sarasota, FL
- NPI 1801831003
-
- Multi-Specialty Clinic/Center
- Sarasota, FL
- NPI 1750769923
-
- Pulmonary Disease Physician
- Sarasota, FL
- NPI 1881851269
-
- Pulmonary Disease Physician
- Naples, FL
- NPI 1033136023
-
- Gynecology Physician
- Sarasota, FL
- NPI 1275525826
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sarasota, FL
- NPI 1245294826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1508142803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 WALDEMERE ST STE 705",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342392913",
"telephone_number": "941-366-5864",
"fax_number": "941-316-9819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 WALDEMERE ST STE 705",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342392913",
"telephone_number": "941-366-5864"
}
],
"practiceLocations": [
{
"address_1": "1700 S Tamiami Trl",
"address_purpose": "LOCATION",
"city": "Sarasota",
"state": "FL",
"postal_code": "342393555",
"country_code": "US",
"telephone_number": "941-917-9000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2600 Laurel Rd E",
"address_purpose": "LOCATION",
"city": "North Venice",
"state": "FL",
"postal_code": "342753226",
"country_code": "US",
"telephone_number": "941-917-9000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Healthcare Way Unit 102",
"address_purpose": "LOCATION",
"city": "North Venice",
"state": "FL",
"postal_code": "342753670",
"country_code": "US",
"telephone_number": "941-366-5864",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CABALLERO",
"first_name": "JENNIFER",
"middle_name": "EDEN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-31",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 9106259",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016967300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.