Jaclyn S Rieben, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9114843 Issued in FL

Practice address

82 Mack Bayou Loop
Santa Rosa Beach, FL 32459-2637

Phone

(850) 233-3376

Fax

(850) 522-8354

NPI assigned

Jan 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA, FL3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Dermatology Group PAGroup PAC ID 9931277233, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southeastern Dermatology Group PA

  dba Dermatology Specialists

  • Dermatology Physician
  • Panama City, FL
  • NPI 1518972231
  Medicare reassignment Care Compare group
• Town Center Orthopaedic Associates, P.C.

  • Orthopaedic Surgery Physician
  • Reston, VA
  • NPI 1487755955

  DC

  Medicare reassignment NPD
• Vascular Associates LLC

  • Specialist
  • Panama City, FL
  • NPI 1821129313
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1972573988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054464",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MACK BAYOU LOOP",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324592637",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Racetrack Rd NE",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325471875",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12907 Panama City Beach Pkwy",
            "address_purpose": "LOCATION",
            "city": "Panama City Beach",
            "state": "FL",
            "postal_code": "324072717",
            "country_code": "US",
            "telephone_number": "850-233-3376",
            "fax_number": "850-522-8354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEBEN",
        "first_name": "JACLYN",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9114843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Clifford Ratcliff, DDS
• John Roger Rebillot, M. A.
• Christine Reitz, OTR/L
• Sarah Reznechek
• Melissa Richmond
• April Rieveschl, PH.D.
• Kevin Riley
• Andrew Scott Robbins
• Thomas Whitfield Roberts, DPM
• Kiran Sehdev Robertson, MD

• Physician Assistant in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.