Individual provider Active NPI

Aida Husovic, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1952141996
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9118850 Issued in FL
Practice address
3857 Mission Dr Unit 4
Jacksonville, FL 32217-3095
Phone
(904) 333-5369
NPI assigned
May 28, 2024
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 9118850 FL Primary

Addresses

Primary practice location

3857 Mission Dr Unit 4
Jacksonville, FL 32217-3095

Mailing address

3857 Mission Dr Unit 4
Jacksonville, FL 32217-3095
Phone (904) 333-5369

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
I20241014002426 FL Practitioner - Physician Assistant 3072045228 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9118850FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Community Health Centers Inc CurrentSince Jul 18, 2024 Accepting new patients
Suncoast Community Health Centers, Inc CurrentSince Jul 18, 2024 Accepting new patients
Suncoast Community Health Centers Inc Past Accepting new patients

Locations

313 S Lakewood Dr
Brandon, FL 33511
Phone (813) 349-7900

13110 Elk Mountain Dr
Riverview, FL 33579
Phone (813) 349-7567

2814 14th Ave SE
Ruskin, FL 33570
Phone (813) 349-7800

Organizations & group practices 3

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": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1952141996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3857 MISSION DR UNIT 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322173095",
            "telephone_number": "904-333-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3857 MISSION DR UNIT 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322173095",
            "telephone_number": "904-333-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSOVIC",
        "first_name": "AIDA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.