Jesse Adams, PA
Individual provider Active NPI Medical Physician Assistant · Clearwater, FL
NPI 1972867935 · NPPES record last updated Sep 30, 2013
Key facts
- NPI
- 1972867935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA9106597 (FL)
- Practice address
- 300 Pinellas St
Clearwater, FL 33756-3804 - Phone
- (727) 461-8537
- NPI assigned
- Jun 25, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120801000326 | FL | Practitioner - Physician Assistant | 1557527835 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9106597 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FL-I Medical Services LLC | Current |
Accepting new patients | |
| FL-I Medical Services LLC | Current |
Accepting new patients | |
| Haven Emergency Physicians | Past | Accepting new patients | |
| Baxley Emergency Physicians LLC | Past | Accepting new patients |
Locations
322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858
502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481
20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9106597 | FL | Yes |
Addresses
Primary practice location
300 Pinellas St
Clearwater, FL 33756-3804
Mailing address
PO Box 17308
Clearwater, FL 33762-0308
Phone (904) 482-1070
Other providers in Clearwater, FL
- Acunique Alternative, P.a.
- Acupuncture & Alternative Medicine
- Badria Christine Adamo
- Anthony Joe Adams
- Jane Adams
- Jessica Marie Adams
- Makenna Adams
- Marycarson Adams
- Michael Adams
- Michael J Adams
All providers in Clearwater, FL · Medical Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.