Individual provider Active NPI

Jillian Ginnetti, PA-C

  • Medical Physician Assistant
  • Tampa, FL
National Provider Identifier
1811520083
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9112826 Issued in FL
Practice address
12780 Race Track Rd Ste 300
Tampa, FL 33626-1306
Phone
(813) 792-9541
Fax
(813) 443-8170
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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 PA9112826 FL
Medical Physician Assistant 363AM0700X PA9112826 FL Primary

Addresses

Primary practice location

12780 Race Track Rd Ste 300
Tampa, FL 33626-1306

Mailing address

12780 Race Track Rd Ste 300
Tampa, FL 33626-1306
Phone (813) 792-9541

Other identifiers 1

IdentifierTypeStateIssuer
113897500MedicaidFL

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
I20220330002636 FL Practitioner - Physician Assistant 2769878768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

12780 Race Track Rd
Suite 300
Tampa, FL 33626-1306
Phone (813) 792-9541

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • Mease Countryside Hospital Hospital, Safety Harbor, FL, CCN 100265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9112826FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Mar 24, 2022 Accepting new patients
Baycare Medical Group, Inc. Physician Assistant Past Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

12780 Race Track Rd
Ste 300
Tampa, FL 33626
Phone (813) 792-9541

Interoperability endpoints

  • Direct secure messaging: jillian.ginnettipa-c@direct.mybaycare.org

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.

Hospital & facility affiliations 4

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": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1811520083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 RACE TRACK RD STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261306",
            "telephone_number": "813-792-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12780 RACE TRACK RD STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261306",
            "telephone_number": "813-792-9541",
            "fax_number": "813-443-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINNETTI",
        "first_name": "JILLIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112826",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9112826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113897500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.