Individual provider Active NPI

Taylor Skye Panichello, PA-C

  • Medical Physician Assistant
  • Clearwater, FL
National Provider Identifier
1790348050
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
9112198 Issued in FL
Practice address
445 Pinellas Street
Suite 400
Clearwater, FL 33756
Phone
(727) 445-1911
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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 9112198 FL Primary

Addresses

Primary practice location

445 Pinellas Street
Suite 400
Clearwater, FL 33756

Mailing address

455 Pinellas St Ste 400
Clearwater, FL 33756-3356
Phone (727) 445-1911

Other practice location 1

12901 Bruce B Downs Blvd # Blvd5
Tampa, FL 33612-4742
Phone (813) 974-0347

Other practice location 2

8839 Bryan Dairy Rd Ste 300
Largo, FL 33777-1207
Phone (727) 394-1911

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
I20240729000622 FL Practitioner - Physician Assistant 7315483120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Florida College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

455 Pinellas St
Suite 400
Clearwater, FL 33756-3356
Phone 72744519923222

8839 Bryan Dairy Rd
Suite 300
Largo, FL 33777-1207
Phone (727) 394-1911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9112198FLMDMedical Physician Assistant

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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.

Hospital & facility affiliations 2

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": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1790348050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PINELLAS ST STE 400",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563356",
            "telephone_number": "727-445-1911",
            "fax_number": "727-445-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 PINELLAS STREET",
            "address_2": "SUITE 400",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33756",
            "telephone_number": "727-445-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12901 Bruce B Downs Blvd # Blvd5",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124742",
            "country_code": "US",
            "telephone_number": "813-974-0347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8839 Bryan Dairy Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337771207",
            "country_code": "US",
            "telephone_number": "727-394-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANICHELLO",
        "first_name": "TAYLOR",
        "middle_name": "SKYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2022-08-04",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9112198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.