Individual provider Active NPI

Jacquelyn Siegel

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1861086860
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
909 N Dale Mabry Hwy Ste 201
Tampa, FL 33609-1251
Phone
(813) 287-9372
Fax
(813) 558-6044
NPI assigned
Feb 22, 2021
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

909 N Dale Mabry Hwy Ste 201
Tampa, FL 33609-1251

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0915
Phone (138) 978-9700

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
I20230808002814 FL Practitioner - Physician Assistant 2264894294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Florida College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3334 Capital Medical Blvd
Suite 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

560 S Lakewood Dr
101 Florida Orthopaedic Institute
Brandon, FL 33511-5015
Phone (813) 978-9700

909 N Dale Mabry Hwy
Florida Orthopaedic Institute
Tampa, FL 33609-1251
Phone (813) 978-9700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III PL Single Specialty CurrentSince Nov 22, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Jul 24, 2023 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Nov 22, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Jul 24, 2023 Accepting new patients
Musculoskeletal Institute Chartered Single Specialty Past Accepting new patients
Musculoskeletal Institute Chartered Past Accepting new patients

Locations

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (229) 393-5185

909 N Dale Mabry Hwy
Tampa, FL 33609
Phone (813) 287-9370

909 N Dale Mabry Hwy
Ste 201
Tampa, FL 33609
Phone (813) 287-9372

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jacquelyn.siegel.1@18802.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1861086860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370915",
            "telephone_number": "138-978-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N DALE MABRY HWY STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091251",
            "telephone_number": "813-287-9372",
            "fax_number": "813-558-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "JACQUELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.