Individual provider Active NPI

Riley Rose Bowers, PA-C

  • Physician Assistant
  • Brandon, FL
National Provider Identifier
1932987658
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117866 Issued in FL
Practice address
1139 Nikki View Dr
Brandon, FL 33511-4879
Phone
(813) 879-8045
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA9117866 FL Primary

Addresses

Primary practice location

1139 Nikki View Dr
Brandon, FL 33511-4879

Mailing address

6421 Congress Ave Ste 113
Boca Raton, FL 33487-2858
Phone (813) 879-8045

Other practice location 1

13015 Summerfield Square Dr
Riverview, FL 33578-7402
Phone (813) 879-8045

Other identifiers 1

IdentifierTypeStateIssuer
11932987658MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ribowers@entaaf.com Direct

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
I20230927001251 FL Practitioner - Physician Assistant 9436503273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

1139 Nikki View Dr
Brandon, FL 33511-4879
Phone (813) 879-8045

13015 Summerfield Square Dr
Riverview, FL 33578-7402
Phone (813) 879-8045

1303 Mosley Dr
Lynn Haven, FL 32444-5625
Phone (850) 784-7722

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9117866FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Oct 2, 2023 Accepting new patients
Lee Memorial Health System CurrentSince Oct 2, 2023 Accepting new patients

Locations

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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 2

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1932987658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 CONGRESS AVE STE 113",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872858",
            "telephone_number": "813-879-8045",
            "fax_number": "813-654-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 NIKKI VIEW DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114879",
            "telephone_number": "813-879-8045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13015 Summerfield Square Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335787402",
            "country_code": "US",
            "telephone_number": "813-879-8045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "RILEY",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11932987658",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ribowers@entaaf.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1139 Nikki View Dr",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335114879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.