Active NPI
Isabel Elena Burgess, PA-C
- Physician Assistant
- Tampa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9120577
- Practice address
- 12902 Usf Magnolia Dr
Tampa, FL 33612-9416 - Phone
- (813) 745-4673
- Fax
- (813) 449-6713
- NPI assigned
- May 23, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110007894 | VA | |
| Physician Assistant | 363A00000X | PA9120577 | FL | Primary |
Addresses
Primary practice location
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Mailing address
PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-4673
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025047600 | Medicaid | FL |
Other names 1
- Isabel Elena Betancourt Otanez
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1215 Lee St
Charlottesville, VA 22908-0816
1240 Lee St
Charlottesville, VA 22908-0817
Phone (434) 243-0321
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (888) 860-2778
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.45 of 100
- Quality
- 79.76
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.07
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9120577 | FL | MD | Physician Assistant |
| 0110007894 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc | Current | Accepting new patients | |
| Rural Health Care, Inc. | Current | Accepting new patients | |
| University of Virginia Physicians Group | Current | Accepting new patients | |
| Rural Health Care Incorporated | Current | Accepting new patients |
Locations
306 Union Ave
Crescent City, FL 32112
Phone (386) 698-1232
100 Commercial Dr
Keystone Hgts, FL 32656
Phone (352) 473-6595
1302 River St
Palatka, FL 32177
Phone (386) 328-0108
12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720
1240 Lee St
Charlottesville, VA 22908
1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500
Interoperability endpoints
- iburgess495293@direct.healthsystem.virginia.edu
Organizations & group practices 5
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.
-
dba Moffitt Medical Group
- Hematology & Oncology Physician
- Tampa, FL
- NPI 1306833595
-
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Charlottesville, VA
- NPI 1033138250
-
dba Aza Health
- Federally Qualified Health Center (FQHC)
- Palatka, FL
- NPI 1871569061
-
dba Aza Health
- Federally Qualified Health Center (FQHC)
- Crescent City, FL
- NPI 1235106618
-
dba Aza Health
- Federally Qualified Health Center (FQHC)
- Daytona Beach, FL
- NPI 1891227179
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Special Hospital
- Tampa, FL
- NPI 1780653618
-
dba UVA Health Sciences Center
- General Acute Care Hospital
- Charlottesville, VA
- NPI 1780630608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767916800000",
"number": "1982195277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 198441",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303848441",
"telephone_number": "813-745-4673",
"fax_number": "813-449-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12902 USF MAGNOLIA DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336129416",
"telephone_number": "813-745-4673",
"fax_number": "813-449-6713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "ISABEL",
"middle_name": "ELENA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-23",
"last_updated": "2026-01-09",
"certification_date": "2026-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110007894",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9120577",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "025047600",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ISABEL",
"last_name": "BETANCOURT OTANEZ",
"middle_name": "ELENA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.