Active NPI
Nicole Renee Donovan, PA-C
- Physician Assistant
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9101636
- Practice address
- 12902 Usf Magnolia Dr
Tampa, FL 33612-9416 - Phone
- (813) 745-7365
- Fax
- (813) 449-8618
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9101636 | FL | Primary |
Addresses
Primary practice location
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Mailing address
PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-7365
Other practice location 1
14547 Bruce B Downs Blvd
Suite D
Tampa, FL 33613-2709
Phone (813) 979-7733
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 291308900 | Medicaid | FL | |
| P00982254 | Other | FL | RR MEDICARE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10901 McKinley Dr
Tampa, FL 33612-6455
Phone (813) 745-4673
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778
16370 Wilton Way
Land O Lakes, FL 34638-3324
Phone (813) 745-7365
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Medical Clinic, LLC | Current | Accepting new patients | |
| Florida Medical Clinic LLC | Current | Accepting new patients | |
| Suncoast Urology PA | Past | Accepting new patients | |
| Mark Alagna MD PA | Past | Accepting new patients | |
| Citrus Urology Associates P a | Past | Accepting new patients |
Locations
14547 Bruce B Downs Blvd
Ste D
Tampa, FL 33613
Phone (813) 971-9850
38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188
Organizations & group practices 6
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.
-
- Hematology & Oncology Physician
- Tampa, FL
- NPI 1306833595
-
- Clinic/Center
- Zephyrhills, FL
- NPI 1821055690
-
- Pharmacy
- Zephyrhills, FL
- NPI 1669548020
-
- Urology Physician
- Homosassa, FL
- NPI 1821060401
-
- Urology Physician
- Hudson, FL
- NPI 1356355200
-
- Urology Physician
- Hudson, FL
- NPI 1467497966
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Tampa, FL
- NPI 1780653618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753833600000",
"number": "1801812342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 198441",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303848441",
"telephone_number": "813-745-7365",
"fax_number": "813-449-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12902 USF MAGNOLIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129416",
"telephone_number": "813-745-7365",
"fax_number": "813-449-8618"
}
],
"practiceLocations": [
{
"address_1": "14547 Bruce B Downs Blvd",
"address_2": "Suite D",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336132709",
"country_code": "US",
"telephone_number": "813-979-7733",
"fax_number": "813-355-5161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DONOVAN",
"first_name": "NICOLE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2025-07-30",
"certification_date": "2025-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9101636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "291308900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00982254",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.