Individual provider Active NPI

Elleanor Sapin Swartz, P.A.-C.

  • Medical Physician Assistant
  • Jacksonville Beach, FL
National Provider Identifier
1972797132
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104222 Issued in FL
Practice address
3200 3Rd St S
Ste 200
Jacksonville Beach, FL 32250-6097
Phone
(904) 249-6110
Fax
(904) 249-6119
NPI assigned
Aug 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104222 FL Primary

Addresses

Primary practice location

3200 3Rd St S
Ste 200
Jacksonville Beach, FL 32250-6097

Mailing address

3200 3Rd St S
Ste 200
Jacksonville Beach, FL 32250-6097
Phone (904) 249-6110

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
I20071029000188 FL Practitioner - Physician Assistant 6305933045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

3200 3Rd St S
Suite 200
Jacksonville Beach, FL 32250-6097
Phone (813) 321-1786

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9104222FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer L Vesper MD PA PastSince Mar 11, 1998 Accepting new patients
Waterside Dermatology PLLC PastSince Aug 1, 2023 Accepting new patients
Douglas K Pierce MD PA Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1972797132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 3RD ST S",
            "address_2": "STE 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506097",
            "telephone_number": "904-249-6110",
            "fax_number": "904-249-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 3RD ST S",
            "address_2": "STE 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506097",
            "telephone_number": "904-249-6110",
            "fax_number": "904-249-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWARTZ",
        "first_name": "ELLEANOR",
        "middle_name": "SAPIN",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.