Individual provider Active NPI

Richard Warren Whittaker III

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1538055074
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121247 Issued in FL
Practice address
10051 5TH St N
St Petersburg, FL 33702-2289
Phone
(727) 527-5272
Fax
(727) 522-7412
NPI assigned
Jun 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9121247 FL Primary

Addresses

Primary practice location

10051 5TH St N
St Petersburg, FL 33702-2289

Mailing address

10051 5TH St N
St Petersburg, FL 33702-2289
Phone (727) 527-5272

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
I20260318000214 FL Practitioner - Physician Assistant 7911481080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Orthopedic Clinic III PLGroup PAC ID 4284532755, 538 clinicians

Practice addresses (Care Compare)

10051 5TH St N
St Petersburg, FL 33702-2289
Phone (727) 527-5272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9121247FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III PL CurrentSince Feb 9, 2026 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Feb 9, 2026 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Feb 9, 2026 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Feb 9, 2026 Accepting new patients

Locations

10051 5th St N
St Petersburg, FL 33702
Phone (727) 828-2314

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1538055074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022289",
            "telephone_number": "727-527-5272",
            "fax_number": "727-522-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10051 5TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022289",
            "telephone_number": "727-527-5272",
            "fax_number": "727-522-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "RICHARD",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-12",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.