Erin Olivia Wade, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117608 Issued in FL

Practice address

4727 Sunbeam Rd Ste 101
Jacksonville, FL 32257-6188

Phone

(904) 512-1899

Fax

(904) 770-7592

NPI assigned

Oct 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Wake Forest University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southside Dermatology, P.a.Group PAC ID 6305063884, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.59 of 100Reported as group

Quality

100

Promoting interoperability

91

Improvement activities

40

Cost

72.81

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewade@dermse.emadirect.md

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.

• Southside Dermatology, P.a.

  • Specialist
  • Jacksonville, FL
  • NPI 1023276607
  Medicare reassignment Care Compare group
• Dermatology Associates of Tallahassee PA

  • Dermatology Physician
  • Tallahassee, FL
  • NPI 1295842672
  Medicare reassignment
• Dermatology Associates of Tallahassee, PA

  • Dermatology Physician
  • Valdosta, GA
  • NPI 1730567504
  NPD

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1811769029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13834",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323173834",
            "telephone_number": "850-205-0615",
            "fax_number": "855-975-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 SUNBEAM RD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576188",
            "telephone_number": "904-512-1899",
            "fax_number": "904-770-7592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1807 3rd St N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322507491",
            "country_code": "US",
            "telephone_number": "904-512-1899",
            "fax_number": "904-770-7592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "ERIN",
        "middle_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Zachary Wacker
• Racquel Denise Waddy
• Kadijo Wade-Thomas, MD
• Alicia Wade
• Crystal Ann Wade, MSN, AG-ACNP-BC
• Michelle Pinto Wade, PA-C
• Roger Dale Wade, RN
• Samantha Jayde Wade, MSW
• Sean Wade, M.D.
• Hani Wadei, MD

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.

Verify at the official NPI Registry.