Individual provider Active NPI

Tatiana Graham Ade, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1629531306
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113745 Issued in FL
Practice address
7011 A C Skinner Pkwy Ste 160
Jacksonville, FL 32256-6953
Phone
(904) 493-3333
Fax
(904) 493-2222
NPI assigned
Apr 10, 2019
Last updated
Aug 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113745 FL Primary

Addresses

Primary practice location

7011 A C Skinner Pkwy Ste 160
Jacksonville, FL 32256-6953

Mailing address

PO Box 551308
Jacksonville, FL 32255-1308
Phone (904) 493-3333

Other practice location 1

205 Zeagler Dr Ste 101
Palatka, FL 32177-3860
Phone (386) 325-2836

Other practice location 2

1681 Eagle Harbor Pkwy Ste B
Fleming Island, FL 32003-4819
Phone (904) 644-0092

Other identifiers 1

IdentifierTypeStateIssuer
113130200MedicaidFL

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
I20220112002141 FL Practitioner - Physician Assistant 7113319690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1465 Kingsley Ave
Orange Park, FL 32073-4504
Phone (904) 644-0092

1675 Eagle Harbor Pkwy
Fleming Island, FL 32003-4802
Phone (904) 644-0092

205 Zeagler Dr
Palatka, FL 32177-3888
Phone (386) 325-2836

7011 A C Skinner Pkwy
Suite 160
Jacksonville, FL 32256-6953
Phone (904) 493-3333

905 Beach Blvd
Jacksonville, FL 32250-4303
Phone (904) 493-3333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.46 of 100Reported as group
Quality
91.35
Promoting interoperability
99
Improvement activities
40
Cost
81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
First Coast Cardiovascular Institute LLC CurrentSince Jan 10, 2022 Accepting new patients
Clearwater Cardiovascular and Interventional Consultants MD PA Past Accepting new patients

Locations

3900 University Blvd S
Jacksonville, FL 32216
Phone (904) 222-6656

7011 A C Skinner Pkwy
Ste 160
Jacksonville, FL 32256
Phone (904) 642-0877

905 Beach Blvd
Jax Bch, FL 32250
Phone (904) 241-8300

1681 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 644-0092

205 Zeagler Dr
Ste 101
Palatka, FL 32177
Phone (321) 806-3949

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEIHCA

Organizations & group practices 3

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 1

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1629531306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551308",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551308",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 A C SKINNER PKWY STE 160",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566953",
            "telephone_number": "904-493-3333",
            "fax_number": "904-493-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Zeagler Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321773860",
            "country_code": "US",
            "telephone_number": "386-325-2836",
            "fax_number": "386-325-2736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1681 Eagle Harbor Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034819",
            "country_code": "US",
            "telephone_number": "904-644-0092",
            "fax_number": "904-644-0099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADE",
        "first_name": "TATIANA",
        "middle_name": "GRAHAM",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113130200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.