Jared Devirgilis, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 9109796 Issued in FL

Practice address

206 2ND St E
Bradenton, FL 34208-1042

Phone

(941) 746-5111

Fax

(941) 745-7233

NPI assigned

Sep 26, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Tennessee LLCGroup PAC ID 0547667552, 141 clinicians

Floyd Physicians LLCGroup PAC ID 6406852375, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jared.devirgilis.1@25094.direct.athenahealth.com

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.

• Floyd Physicians, LLC

  dba Atrium Health Floyd Specialty Care

  • Neonatal-Perinatal Medicine Physician
  • Rome, GA
  • NPI 1992814586
  Medicare reassignment Care Compare group NPD
• Privia Medical Group Tennessee LLC

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1376110858
  Medicare reassignment Care Compare group NPD
• Premier Orthopaedics & Sports Medicine PLC

  dba Hughston Clinic Orthopaedics

  • Orthopaedic Surgery Physician
  • Nashville, TN
  • NPI 1972577351
  Medicare reassignment NPD
• Ap of Nashville, LLC

  • Surgical Physician Assistant
  • Nashville, TN
  • NPI 1174990899
  Medicare reassignment
• Premier Orthopaedics & Sports Medicine, PLC

  dba Hughston Clinic Orthopaedics

  • Durable Medical Equipment & Medical Supplies
  • Murfreesboro, TN
  • NPI 1861029084
  NPD
• Privia Medical Group Tennessee LLC

  dba Sports Ortho Urgent Care

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Nashville, TN
  • NPI 1215694229
  NPD

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1548719065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATTN: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "941-746-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 2ND ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081042",
            "telephone_number": "941-746-5111",
            "fax_number": "941-745-7233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1895 Kingsley Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734453",
            "country_code": "US",
            "telephone_number": "904-263-5557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVIRGILIS",
        "first_name": "JARED",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-26",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9109796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yeni Detrinidad
• Edwin Detweiler III, O.D.
• Micaela Devane
• Martha Jean Devernoe, RN
• Taylor Victoria Devinney, APRN
• Vivek Kanwal Dewan
• Tamela C Deweese-Giddings, MA, BCBA
• Dialysis 2U LLC
• Diamond Diabetic Services Inc
• Adam Diamond

• Surgical Physician Assistant in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.

Verify at the official NPI Registry.