Individual provider Active NPI

Andrea Rose Masson

  • Physician Assistant
  • Pensacola, FL
National Provider Identifier
1508439977
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9122245 Issued in FL
Practice address
125 Baptist Way Ste 4a
Pensacola, FL 32503-2274
Phone
(448) 227-6360
Fax
(850) 437-8649
NPI assigned
Jul 22, 2021
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 333904 LA
Physician Assistant 363A00000X PA9122245 FL Primary

Addresses

Primary practice location

125 Baptist Way Ste 4a
Pensacola, FL 32503-2274

Mailing address

PO Box 95590
South Jordan, UT 84095-0590
Phone (801) 352-9500

Other practice location 1

9915 Tunnel Way
Louisville, KY 40291-3375
Phone (502) 592-1433

Other practice location 2

1040 Gulf Breeze Pkwy Ste 205
Gulf Breeze, FL 32561-7808
Phone (850) 469-0642

Other practice location 3

1549 E 70th St Ste 300
Shreveport, LA 71105-5056
Phone (318) 300-3898

Other practice location 4

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0000

Other identifiers 1

IdentifierTypeStateIssuer
15835900OtherCAQH

Other names 1

  • Andrea Rose Just Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20221130001082 LA Practitioner - Physician Assistant 7517335250 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arklatex Medical Consultants a Medical Corporation CurrentSince Oct 21, 2022 Accepting new patients
Shriners Hospitals for Children Physician Assistant CurrentSince May 1, 2025 Accepting new patients
Shriners Hospitals for Children CurrentSince May 1, 2025 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
University Health Shreveport LLC Physician Assistant Past Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

1549 E 70th St
Ste 300
Shreveport, LA 71105
Phone (318) 300-3898

3100 Samford Ave
Shreveport, LA 71103
Phone (318) 222-5704

8731 Park Plaza Dr
Shreveport, LA 71105
Phone (318) 524-7144

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCHDDD

Organizations & group practices 9

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1508439977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95590",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840950590",
            "telephone_number": "801-352-9500",
            "fax_number": "801-352-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BAPTIST WAY STE 4A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032274",
            "telephone_number": "448-227-6360",
            "fax_number": "850-437-8649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9915 Tunnel Way",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402913375",
            "country_code": "US",
            "telephone_number": "502-592-1433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1040 Gulf Breeze Pkwy Ste 205",
            "address_purpose": "LOCATION",
            "city": "Gulf Breeze",
            "state": "FL",
            "postal_code": "325617808",
            "country_code": "US",
            "telephone_number": "850-469-0642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1549 E 70th St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055056",
            "country_code": "US",
            "telephone_number": "318-300-3898",
            "fax_number": "318-797-4241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1541 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSON",
        "first_name": "ANDREA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "333904",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9122245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15835900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "JUST",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.