Jade Luciana Carbonelli, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9170 Oakhurst Rd Ste 1
Seminole, FL 33776-2112

Phone

(813) 321-1786

Fax

(813) 321-1787

NPI assigned

Feb 9, 2023

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jade Caputo Former name

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Suncoast Skin Solutions

  • Dermatology Physician
  • Lutz, FL
  • NPI 1487827416
  Medicare reassignment Care Compare group
• Douglas K Pierce MD PA

  dba The Dermatology Clinic

  • Procedural Dermatology Physician
  • Largo, FL
  • NPI 1053515379
  NPD (past)

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1619674660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18228 N US HIGHWAY 41",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494400",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9170 OAKHURST RD STE 1",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337762112",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONELLI",
        "first_name": "JADE",
        "middle_name": "LUCIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADE",
            "last_name": "CAPUTO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Caliri, BCBA
• Tara Koza Camargo, O.D.
• Noelle Campbell, APRN
• Julianna Capobianco
• Capstone Eye Care Group of Florida LLC
• Carlos E Cardenas Peralta, DMD
• Caring About Living Individuals Project
• Caring Floridians Nurse Registry LLC
• Carmen R Damiani DO PA (Center For Women & Family)
• Carring Community Counseling

• Physician Assistant in Seminole, FL
• Providers in Seminole, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.