Individual provider Active NPI

Elianna Reynolds, PA-C

  • Physician Assistant
  • Land O' Lakes, FL
National Provider Identifier
1528628278
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117852 Issued in FL
Practice address
2435 Bexley Village Dr Ste 200
Land O Lakes, FL 34638-2721
Phone
(978) 452-9700
NPI assigned
Jun 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA7735 MA
Physician Assistant 363A00000X PA9117852 FL Primary

Addresses

Primary practice location

2435 Bexley Village Dr Ste 200
Land O Lakes, FL 34638-2721

Mailing address

2435 Bexley Village Dr Ste 200
Land O Lakes, FL 34638-2721

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717001650 FL Practitioner - Physician Assistant 6507270683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

2435 Bexley Village Dr
Suite 200
Land O Lakes, FL 34638-2721
Phone (813) 467-4771

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

8702 Hunters Lake Dr
Suite 100
Tampa, FL 33647-2855
Phone (813) 467-4700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9117852FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Diagnostic Services, Inc PastSince Feb 1, 2022 Accepting new patients

Organizations & group practices 2

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 2

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": "1560556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1528628278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 BEXLEY VILLAGE DR STE 200",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346382721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 BEXLEY VILLAGE DR STE 200",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346382721",
            "telephone_number": "978-452-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ELIANNA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-15",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA7735",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O' Lakes, FL

Sources for this page

Verify at the official NPI Registry.