Anthony John Jimenez, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA3216 Issued in FL

Practice address

403 S Kings Ave Ste 201
Brandon, FL 33511-5962

Phone

(813) 872-4992

Fax

(813) 864-4030

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: anthony.jimenez.p2@direct.painreliefcenters.nextgenshare.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.

• Tampa Pain Relief Center, Inc.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tampa, FL
  • NPI 1871543751
  Medicare reassignment
• Florida Pain Relief Group PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tampa, FL
  • NPI 1376994608
  NPD (past)
• Musculoskeletal Institute Chartered

  • Orthopaedic Surgery Physician
  • Zephyrhills, FL
  • NPI 1467305839
  NPD (past)
• United Surgical Assistants NA Inc

  • Specialist
  • Tampa, FL
  • NPI 1326081654
  NPD (past)

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1568426906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 S KINGS AVE",
            "address_2": "STE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115962",
            "telephone_number": "813-872-4492",
            "fax_number": "813-490-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 S KINGS AVE STE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115962",
            "telephone_number": "813-872-4992",
            "fax_number": "813-864-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA3216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970022306",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290370901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica K. Mahoney, Psy.D., P.a.
• Nevaeh Liara Jessup, RBT
• Dayna Jetmore
• Lawanya Jeyaselvan, MD
• Linzi Jiang, MD
• Felix Jimenez, D.D.S.
• Jeisy Marie Jimenez, BCBA
• John Cottam MD PA
• John V Tran DPM MPH PA
• Dylan Johns

• Surgical Physician Assistant in Brandon, FL
• Providers in Brandon, 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 Sep 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.