Individual provider Active NPI

Adeline Rose Sutton, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1831042076
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9905 Old Saint Augustine Rd Ste 200
Jacksonville, FL 32257-8983
Phone
(904) 296-1313
Fax
(866) 903-4727
NPI assigned
Feb 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X FL Primary

Addresses

Primary practice location

9905 Old Saint Augustine Rd Ste 200
Jacksonville, FL 32257-8983

Mailing address

900 Village Square Xing Ste 290
Palm Beach Gardens, FL 33410-4552
Phone (239) 313-2517

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
I20260407000965 FL Practitioner - Physician Assistant 2365917473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

870 Sailfish Dr
Atlantic Beach, FL 32233-4217

900 Village Square Xing
Suite 290
Palm Beach Gardens, FL 33410-4547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1831042076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VILLAGE SQUARE XING STE 290",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104552",
            "telephone_number": "239-313-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9905 OLD SAINT AUGUSTINE RD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578983",
            "telephone_number": "904-296-1313",
            "fax_number": "866-903-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "ADELINE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.