Individual provider Active NPI

Jay Allen Spinka, PA-C

  • Medical Physician Assistant
  • Lake Worth, FL
National Provider Identifier
1548223134
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101432 Issued in FL
Practice address
2290 10TH Ave N Ste 401
Lake Worth, FL 33461-6609
Phone
(561) 284-8455
NPI assigned
Apr 6, 2006
Last updated
May 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9101432 FL Primary

Addresses

Primary practice location

2290 10TH Ave N Ste 401
Lake Worth, FL 33461-6609

Mailing address

6415 Lake Worth Rd Ste 302
Greenacres, FL 33463-2906

Other practice location 1

3335 Burns Rd Ste 200
Palm Beach Gardens, FL 33410-4311
Phone (561) 570-2501

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
I20050928001095 FL Practitioner - Physician Assistant 3779518782 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9101432FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vero Beach Surgery Center LLC Past Accepting new patients
Omar David Hussamy MD PA PastSince Jul 1, 1999 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jay.spinka.1@25843.direct.athenahealth.com

Organizations & group practices 3

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1548223134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 LAKE WORTH RD STE 302",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334632906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 10TH AVE N STE 401",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616609",
            "telephone_number": "561-284-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3335 Burns Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334104311",
            "country_code": "US",
            "telephone_number": "561-570-2501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPINKA",
        "first_name": "JAY",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.