Individual provider Active NPI

Alicia Elliott Caldwell, PA-C

  • Physician Assistant
  • Miramar Beach, FL
National Provider Identifier
1699536599
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118873 Issued in FL
Practice address
7720 US Highway 98 W Ste 110
Miramar Beach, FL 32550-7231
Phone
(850) 267-1603
NPI assigned
Jan 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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 PA9118873 FL Primary

Addresses

Primary practice location

7720 US Highway 98 W Ste 110
Miramar Beach, FL 32550-7231

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other names 1

  • Alicia Lee Elliott Former name

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
I20241007002457 FL Practitioner - Physician Assistant 6305377961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

36500 Emerald Coast Pkwy
Destin, FL 32541-4713
Phone (850) 416-1575

7720 US Hwy 98 W
Suite 210
Miramar Beach, FL 32550-7231
Phone (850) 416-2477

7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 267-1603

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Sacred Heart Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
Northside Surgical Professional Services LLC PastSince Jan 1, 2024 Accepting new patients
Atlanta Colon and Rectal Surgery, PA PastSince Jan 1, 2024 Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

7720 US Highway 98 W
Ste 110
Miramar Beach, FL 32550
Phone (850) 267-1603

Interoperability endpoints

  • Direct secure messaging: alicia.caldwell.1@9582.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1699536599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 US HIGHWAY 98 W STE 110",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507231",
            "telephone_number": "850-267-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "ALICIA",
        "middle_name": "ELLIOTT",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "ELLIOTT",
            "middle_name": "LEE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miramar Beach, FL

Sources for this page

Verify at the official NPI Registry.