Individual provider Active NPI

Jesus Antatico Macrohon

  • Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1770189656
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11006709 Issued in FL
Practice address
1839 Central Ave
St Petersburg, FL 33713-8900
Phone
(727) 322-1054
Fax
(727) 322-2725
NPI assigned
Dec 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11006709 FL Primary

Addresses

Primary practice location

1839 Central Ave
St Petersburg, FL 33713-8900

Mailing address

1839 Central Ave
St Petersburg, FL 33713-8900
Phone (727) 322-1054

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
I20241119000708 FL Practitioner - Nurse Practitioner 5597290221 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Professional Health Care of Pinellas, LLCGroup PAC ID 1658274675, 88 clinicians
Eduardo Palanca MD PAGroup PAC ID 5799902524, 3 clinicians

Practice addresses (Care Compare)

1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054

2901 Rigsby LN
Safety Harbor, FL 34695-4828
Phone (727) 724-8777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11006709FLMDNurse Practitioner
APRN11008709FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP Nurse Practitioner CurrentSince Nov 1, 2024 Accepting new patients
Eduardo Palanca MD PA CurrentSince Sep 17, 2024 Accepting new patients

Locations

549 Sky Harbor Dr
Bldg 31
Clearwater, FL 33759
Phone (727) 724-6800

1840 Mease Dr
Ste 315
Safety Harbor, FL 34695
Phone (727) 631-1592

2901 Rigsby Ln
Safety Harbor, FL 34695
Phone (727) 218-8870

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1770189656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-322-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-322-1054",
            "fax_number": "727-322-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACROHON",
        "first_name": "JESUS",
        "middle_name": "ANTATICO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-07",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11006709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.