Individual provider Active NPI

Ellen R Fortier, PA

  • Medical Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1699754002
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 0003227 Issued in FL
Practice address
2191 9TH Ave N
Suite 240
St Petersburg, FL 33713-7146
Phone
(727) 821-7163
Fax
(727) 822-6017
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 0003227 FL Primary

Addresses

Primary practice location

2191 9TH Ave N
Suite 240
St Petersburg, FL 33713-7146

Mailing address

3212 W Fielder St
Tampa, FL 33611-2912
Phone (813) 966-1699

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
PA 0003227FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Daivd J Hobbs MD PA Past Accepting new patients

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1699754002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 W FIELDER ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336112912",
            "telephone_number": "813-966-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 9TH AVE N",
            "address_2": "SUITE 240",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337137146",
            "telephone_number": "727-821-7163",
            "fax_number": "727-822-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIER",
        "first_name": "ELLEN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 0003227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.