Individual provider Active NPI

Julie Christine Sacerdote, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1871085571
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111250 Issued in FL
Practice address
2727 W Dr Martin Luther King Jr Blvd Ste 460
Tampa, FL 33607-6001
Phone
(813) 879-4328
Fax
(813) 443-8152
NPI assigned
May 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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 PA9111250 FL Primary

Addresses

Primary practice location

2727 W Dr Martin Luther King Jr Blvd Ste 460
Tampa, FL 33607-6001

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-1355

Other identifiers 1

IdentifierTypeStateIssuer
106683600MedicaidFL

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
I20181115002684 FL Practitioner - Physician Assistant 8224382932 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neuroscience Associates IncGroup PAC ID 6800025131, 10 clinicians

Practice addresses (Care Compare)

925 Toppino Dr
Key West, FL 33040-4269
Phone (305) 296-2212

Hospital & facility affiliations

  • Island Home Care Home health agency, Key West, FL, CCN 109772
  • Lower Keys Medical Center Hospital, Key West, FL, CCN 100150
  • Fishermen'S Community Hospital Hospital, Marathon, FL, CCN 101312

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neuroscience Associates Inc CurrentSince Jan 22, 2024 Accepting new patients
Baycare Medical Group, Inc. Physician Assistant CurrentSince Jul 6, 2020 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jul 6, 2020 Accepting new patients
Palm Beach Neurosurgery 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

1111 12th St
Ste 212
Key West, FL 33040
Phone (305) 296-2212

925 Toppino Dr
Key West, FL 33040
Phone (305) 296-2212

2727 W Mlk Blvd
Ste 460
Tampa, FL 33607
Phone (813) 879-4328

Organizations & group practices 5

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 3

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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1871085571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-532-1355",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W DR MARTIN LUTHER KING JR BLVD STE 460",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076001",
            "telephone_number": "813-879-4328",
            "fax_number": "813-443-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACERDOTE",
        "first_name": "JULIE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106683600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.