Individual provider Active NPI

Swetha Sundaralingam Jean, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1699285684
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111027 Issued in FL
Practice address
8990 R G Skinner Pkwy
Jacksonville, FL 32256-4020
Phone
(904) 519-6555
Fax
(904) 519-6550
NPI assigned
Oct 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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 PA9111027 FL Primary

Addresses

Primary practice location

8990 R G Skinner Pkwy
Jacksonville, FL 32256-4020

Mailing address

8990 R G Skinner Pkwy
Jacksonville, FL 32256-4020
Phone (904) 519-6555

Other practice location 1

274 3rd Ave S
Jacksonville, FL 32250-6727
Phone (904) 249-3373

Other practice location 2

1679 Eagle Harbor Pkwy Ste B
Fleming Island, FL 32003-4816
Phone (904) 264-1958

Other names 1

  • Swetha Leana Sundaralingam Former name

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

LicenseStateTypeSpecialty
PA9111027FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: swetha.jean.1@8042.direct.athenahealth.com

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1699285684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8990 R G SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564020",
            "telephone_number": "904-519-6555",
            "fax_number": "904-519-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 R G SKINNER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564020",
            "telephone_number": "904-519-6555",
            "fax_number": "904-519-6550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "274 3rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322506727",
            "country_code": "US",
            "telephone_number": "904-249-3373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1679 Eagle Harbor Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034816",
            "country_code": "US",
            "telephone_number": "904-264-1958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEAN",
        "first_name": "SWETHA",
        "middle_name": "SUNDARALINGAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SWETHA",
            "last_name": "SUNDARALINGAM",
            "middle_name": "LEANA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.