Individual provider Active NPI

Angela Yavny, PA-C

  • Physician Assistant
  • Fernandina Beach, FL
National Provider Identifier
1740758465
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9111616 Issued in FL
Practice address
22371 Flora Parke Xing
Fernandina Beach, FL 32034-8000
Phone
(904) 296-1313
Fax
(904) 903-4727
NPI assigned
Nov 12, 2018
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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 9111616 FL Primary

Addresses

Primary practice location

22371 Flora Parke Xing
Fernandina Beach, FL 32034-8000

Mailing address

900 Village Square Xing Ste 290
Palm Beach Gardens, FL 33410-4552
Phone (239) 313-2517

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
I20201223000196 FL Practitioner - Physician Assistant 5799197398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

1015 Crosspointe Dr
Naples, FL 34110-0949
Phone (239) 596-9075

14840 Tamiami TRL
North Port, FL 34287-2701
Phone (941) 564-1542

22371 Flora Parke Xing
Fernandina Beach, FL 32034-8000
Phone (904) 296-1313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9111616FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Oct 20, 2025 Accepting new patients
Scott D Warren MD PA Past Accepting new patients

Locations

22371 Flora Parke Xing
Fernandina Beach, FL 32034
Phone (904) 296-1313

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1740758465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VILLAGE SQUARE XING STE 290",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104552",
            "telephone_number": "239-313-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22371 FLORA PARKE XING",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348000",
            "telephone_number": "904-296-1313",
            "fax_number": "904-903-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAVNY",
        "first_name": "ANGELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.