Individual provider Active NPI

Jessica Rae Harrell, MD

  • Internal Medicine Physician
  • Clearwater, FL
National Provider Identifier
1578004768
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME144790 Issued in FL
Practice address
300 Pinellas St
Clearwater, FL 33756-3804
Phone
(727) 316-5033
NPI assigned
Mar 20, 2017
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME144790 FL Primary

Addresses

Primary practice location

300 Pinellas St
Clearwater, FL 33756-3804

Mailing address

800 32ND Ave N Apt 3
St Petersburg, FL 33704-1259
Phone (407) 376-5553

Other practice location 1

6850 Lake Nona Blvd
Orlando, FL 32827-7408
Phone (321) 697-1736

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127001605 FL Practitioner - Internal Medicine 2466866710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Univ of Central Florida, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunstate Physicians LLCGroup PAC ID 3577813617, 14 clinicians

Practice addresses (Care Compare)

801 W Bay Dr
Suite 321
Largo, FL 33770-3227
Phone (727) 316-5033

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME144790FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Internal Medicine Current Accepting new patients
Baycare Medical Group, Inc CurrentSince Dec 26, 2020 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Dec 26, 2020 Accepting new patients
Sunstate Physicians LLC Internal Medicine CurrentSince Sep 2, 2021 Accepting new patients

Locations

2234 N Federal Hwy
Boca Raton, FL 33431
Phone (561) 306-5469

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

801 West Bay Dr
Ste 321
Largo, FL 33770
Phone (561) 302-6086

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

Interoperability endpoints

  • Direct secure messaging: jessica.harrell@direct.mybaycare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1578004768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 32ND AVE N APT 3",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337041259",
            "telephone_number": "407-376-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-316-5033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6850 Lake Nona Blvd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328277408",
            "country_code": "US",
            "telephone_number": "321-697-1736",
            "fax_number": "407-697-3923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2022-06-02",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME144790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.