Individual provider Active NPI

Elly Shaff, PA-C

  • Physician Assistant
  • Hudson, FL
National Provider Identifier
1730079005
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9120357 Issued in FL
Practice address
7614 Jacque Rd Ste a
Hudson, FL 34667-7195
Phone
(727) 862-8548
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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 9120357 FL Primary

Addresses

Primary practice location

7614 Jacque Rd Ste a
Hudson, FL 34667-7195

Mailing address

401 N Fairview St
Lock Haven, PA 17745-2342

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
I20250912000322 FL Practitioner - Physician Assistant 2062915366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Urology Partners LLPGroup PAC ID 2062574924, 66 clinicians

Practice addresses (Care Compare)

10441 Quality Dr
Suite 201
Spring Hill, FL 34609-9651
Phone (352) 596-0786

11373 Cortez Blvd
Brooksville, FL 34613-5405
Phone (352) 596-0786

12408 N 56TH St
Suite 1
Temple Terrace, FL 33617-1522
Phone (813) 980-3104

7614 Jacque Rd
Suite a
Hudson, FL 34667-7195
Phone (727) 862-8548

Hospital & facility affiliations

  • HCA Florida Oak Hill Hospital Hospital, Brooksville, FL, CCN 100264
  • HCA Florida Bayonet Point Hospital Hospital, Hudson, FL, CCN 100256
  • Tampa General Hospital Brooksville Hospital, Brooksville, FL, CCN 100071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9120357FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Provider Network Inc PastSince Jun 1, 2022 Accepting new patients
Florida Urology Partners LLP PastSince Nov 17, 2019 Accepting new patients
V. Rao Emandi MD PA Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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 4

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1730079005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N FAIRVIEW ST",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177452342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7614 JACQUE RD STE A",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677195",
            "telephone_number": "727-862-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFF",
        "first_name": "ELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9120357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.