Individual provider Active NPI

Tracy Elizabeth Biagioli, PA

  • Medical Physician Assistant
  • Englewood, FL
National Provider Identifier
1780215566
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9112695 Issued in FL
Practice address
714 Doctors Dr
Englewood, FL 34223-3992
Phone
(941) 460-1300
Fax
(866) 504-3674
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9112695 FL
Medical Physician Assistant 363AM0700X PA9112695 FL Primary

Addresses

Primary practice location

714 Doctors Dr
Englewood, FL 34223-3992

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other practice location 1

5500 Pinebrook Rd Ste 202
North Venice, FL 34275-3678
Phone (941) 408-0500

Other identifiers 1

IdentifierTypeStateIssuer
111346600MedicaidFL

Other names 1

  • Tracy Elizabeth Biagioli 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
I20200224000909 FL Practitioner - Physician Assistant 0941637474 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1780215566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 DOCTORS DR",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233992",
            "telephone_number": "941-460-1300",
            "fax_number": "866-504-3674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 Pinebrook Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "North Venice",
            "state": "FL",
            "postal_code": "342753678",
            "country_code": "US",
            "telephone_number": "941-408-0500",
            "fax_number": "941-496-8558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIAGIOLI",
        "first_name": "TRACY",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112695",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9112695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111346600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "BIAGIOLI",
            "middle_name": "ELIZABETH",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Englewood, FL

Sources for this page

Verify at the official NPI Registry.