Individual provider Active NPI

Janelle V Dudley, P.A.

  • Medical Physician Assistant
  • Clearwater, FL
National Provider Identifier
1629035993
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9103041 Issued in FL
Practice address
3301 N McMullen Booth Rd
Clearwater, FL 33761-2014
Phone
(872) 231-3162
Fax
(702) 977-1496
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 PA9103041 FL Primary

Addresses

Primary practice location

3301 N McMullen Booth Rd
Clearwater, FL 33761-2014

Mailing address

PO Box 7410884
Chicago, IL 60674-0884
Phone (702) 899-0595

Other names 1

  • Janelle L Vargo Former name

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
I20080212000264 FL Practitioner - Physician Assistant 4789767914 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9103041FLMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1629035993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7410884",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740884",
            "telephone_number": "702-899-0595",
            "fax_number": "702-977-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N MCMULLEN BOOTH RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612014",
            "telephone_number": "872-231-3162",
            "fax_number": "702-977-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "JANELLE",
        "middle_name": "V",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANELLE",
            "last_name": "VARGO",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.