Active NPI
Jordin Lee Ellingson, PA-C
- Physician Assistant
- Oldsmar, FL
National Provider Identifier
1922625326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9113176
- Practice address
- 3919 Tampa Rd
Oldsmar, FL 34677-3114 - Phone
- (727) 733-6111
- Fax
- (727) 733-6002
- NPI assigned
- Jul 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9113176 | FL | Primary |
Addresses
Primary practice location
3919 Tampa Rd
Oldsmar, FL 34677-3114
Mailing address
3919 Tampa Rd
Oldsmar, FL 34677-3114
Phone (706) 499-0203
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3919 Tampa Rd
Oldsmar, FL 34677-3114
Phone (727) 733-6111
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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.
-
- Multi-Specialty Clinic/Center
- Oldsmar, FL
- NPI 1467696062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769472000000",
"number": "1922625326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3919 TAMPA RD",
"city": "OLDSMAR",
"state": "FL",
"postal_code": "346773114",
"telephone_number": "706-499-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3919 TAMPA RD",
"city": "OLDSMAR",
"state": "FL",
"postal_code": "346773114",
"telephone_number": "727-733-6111",
"fax_number": "727-733-6002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLINGSON",
"first_name": "JORDIN",
"middle_name": "LEE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-01",
"last_updated": "2026-01-27",
"certification_date": "2026-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9113176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oldsmar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.