Raven Alexys Coe, MPAS, PA-C
Individual provider Active NPI Physician Assistant · Seffner, FL
NPI 1639814577 · NPPES record last updated May 4, 2022
Key facts
- NPI
- 1639814577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PAT9115879 (FL)
- Practice address
- 4018 Highview Rd
Seffner, FL 33584-5202 - Phone
- (813) 651-4100
- NPI assigned
- May 4, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Transitional Pain and Specialty Group
Advanced Pain Management Inc
Practice addresses (Care Compare)
1307 W Kennedy Blvd
Tampa, FL 33606-1848
Phone (813) 893-6000
27810 Summergate Blvd
Wesley Chapel, FL 33544-6919
Phone (813) 388-2948
780 Dunlawton Ave
Suite 103
Port Orange, FL 32127-4252
Phone (386) 671-0600
Hospital & facility affiliations
- Adventhealth Tampa
- Adventhealth Zephyrhills
- Adventhealth Wesley Chapel
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20230501003082 | FL | Practitioner - Physician Assistant | 9830554666 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAT9115879 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Pain Management Inc | Current |
Accepting new patients | |
| Tampa General Hospital | Current | Accepting new patients | |
| Advanced Pain Management Inc | Current |
Accepting new patients |
Locations
325 Clyde Morris Blvd
Ste 400
Ormond Beach, FL 32174
Phone (386) 671-0600
780 Dunlawton Ave
Ste 103
Port Orange, FL 32127
Phone (386) 671-0600
11946 Boyette Rd
Riverview, FL 33569
2805 54th Ave N
St Petersburg, FL 33714
Phone (727) 613-1749
508 S Habana Ave
Ste 360
Tampa, FL 33609
Phone (813) 474-3636
27810 Summergate Blvd
Wesley Chapel, FL 33544
Phone (813) 534-6269
Interoperability endpoints
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
- rcoe280760@direct.tgh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAT9115879 | FL | Yes |
Addresses
Primary practice location
4018 Highview Rd
Seffner, FL 33584-5202
Mailing address
222 SW Lincoln Cir N
St Petersburg, FL 33703-1311
Phone (954) 599-5379
NPI Registry JSON
{
"created_epoch": "1651622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1639814577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 SW LINCOLN CIR N",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337031311",
"telephone_number": "954-599-5379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4018 HIGHVIEW RD",
"city": "SEFFNER",
"state": "FL",
"postal_code": "335845202",
"telephone_number": "813-651-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COE",
"first_name": "RAVEN",
"middle_name": "ALEXYS",
"credential": "MPAS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-04",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PAT9115879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seffner, FL
- Reyna Chon
- Christ House International Inc
- Sevette Clark
- Clayton Health Services, LLC
- Craig Clements
- Gerald Sheldon Cohen
- Colet Coke
- Dwight Colston
- Connie Belcher
- Dayna Cook
All providers in Seffner, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2022. 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.