Individual provider Active NPI

Angelita Michelle Kaylor, PA-S

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1922803485
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9120870 Issued in FL
Practice address
5150 Belfort Rd BLDG 400
Jacksonville, FL 32256-6026
Phone
(904) 580-4730
NPI assigned
Feb 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 9120870 FL Primary

Addresses

Primary practice location

5150 Belfort Rd BLDG 400
Jacksonville, FL 32256-6026

Mailing address

5150 Belfort Rd BLDG 400
Jacksonville, FL 32256-6026

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
I20251022000490 FL Practitioner - Physician Assistant 1951899939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ibrahim Heart Clinic PLLCGroup PAC ID 4688958648, 43 clinicians

Practice addresses (Care Compare)

5150 Belfort Rd
BLDG 400
Jacksonville, FL 32256-6026
Phone (904) 580-4730

Hospital & facility affiliations

  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9120870FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ibrahim Heart Clinic PLLC CurrentSince Sep 29, 2025 Accepting new patients

Locations

215 S US Highway 17
East Palatka, FL 32131
Phone (386) 232-9203

5150 Belfort Rd
Bldg 400
Jacksonville, FL 32256
Phone (904) 296-0900

319 W Call St
Ste B
Starke, FL 32091
Phone (904) 368-9102

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.

Hospital & facility affiliations 1

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": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1922803485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 BELFORT RD BLDG 400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 BELFORT RD BLDG 400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566026",
            "telephone_number": "904-580-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYLOR",
        "first_name": "ANGELITA",
        "middle_name": "MICHELLE",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9120870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.