Anna Marie Pittard
Individual provider Active NPI Physician Assistant · Waycross, GA
NPI 1629544358 · NPPES record last updated Dec 9, 2025
Key facts
- NPI
- 1629544358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA9114177 (FL)
- Practice address
- 1900 Tebeau St
Waycross, GA 31501 - Phone
- (912) 283-3030
- NPI assigned
- Oct 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Florida Jacksonville Physicians, Inc.
Practice addresses (Care Compare)
655 W 8TH St
Jacksonville, FL 32231-6511
Phone (904) 244-6340
Merit-based Incentive Payment System (MIPS)
- Final score
- 59.59 of 100
- Quality
- 59.93
- Promoting interoperability
- 0
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200117001693 | GA | Practitioner - Physician Assistant | 4688009764 | Reassigns benefits to 1 organization |
| I20211116002723 | FL | Practitioner - Physician Assistant | 4688009764 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9114177 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians Inc | Current |
Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current |
Accepting new patients |
Locations
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404
Interoperability endpoints
- abogdanov606576@direct.shands.ufl.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9114177 | FL | Yes |
| Physician Assistant | 363A00000X |
Addresses
Primary practice location
1900 Tebeau St
Waycross, GA 31501
Mailing address
220 Riverside Ave Unit 653
Jacksonville, FL 32202-4963
Other practice location 1
655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 244-0411
Other providers in Waycross, GA
- Amanda Gayle Petty
- Pharmacy Services Inc.
- Kari L Piestrak
- Robert Sumner Pilcher
- Pineview Physical Therapy
- Barbara D Pittman
- Porter Healthcare Solutions LLC
- Shelonda A Porter
- Deanna Holland Powell
- Prasanna S. Srinagesh MD PC
All providers in Waycross, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.