Active NPI
Pierre Marie Yanick Exantus, PA
- Physician Assistant
- Clermont, FL
National Provider Identifier
1669100608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9138
- Practice address
- 140 Pacific Ave
Clermont, FL 34711-7194 - Phone
- (954) 479-9653
- NPI assigned
- Aug 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9138 | AZ | Primary |
| Physician Assistant | 363A00000X | PACN77 | FL |
Addresses
Primary practice location
140 Pacific Ave
Clermont, FL 34711-7194
Mailing address
140 Pacific Ave
Clermont, FL 34711-7194
Phone (954) 479-9653
Other practice location 1
11903 Southern Blvd Ste 108
Royal Palm Beach, FL 33411-7644
Phone (561) 448-4475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9138 | AZ | MD | Physical Therapist |
| PACN77 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757462400000",
"number": "1669100608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 PACIFIC AVE",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347117194",
"telephone_number": "954-479-9653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 PACIFIC AVE",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347117194",
"telephone_number": "954-479-9653"
}
],
"practiceLocations": [
{
"address_1": "11903 Southern Blvd Ste 108",
"address_purpose": "LOCATION",
"city": "Royal Palm Beach",
"state": "FL",
"postal_code": "334117644",
"country_code": "US",
"telephone_number": "561-448-4475",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EXANTUS",
"first_name": "PIERRE MARIE",
"middle_name": "YANICK",
"name_prefix": "Dr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-09",
"last_updated": "2025-09-10",
"certification_date": "2025-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "9138",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PACN77",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.