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NPI · 1104136399 · NPPES-sourced

Jared Destackelberg PA

ActivePhysician Assistant
NPI Number
1104136399
Type 1 · Individual
Taxonomy Code
363A00000X
Contact
(352) 622-3360
License FL · PAT 9105672
Last Updated
Enumerated
Primary practice addressFL · 34471-8215
1901 Se 18th Ave, Ste 101Ocala, FL 34471-8215
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About this NPIWhat this record shows.

NPI 1104136399 is registered to Jared Destackelberg PA, a Physician Assistant practising at 1901 Se 18th Ave, Ste 101 in Ocala, Florida. Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Jared Destackelberg PA has been enumerated in the National Provider Identifier (NPI) registry since 2010.

Provider type
Individual (Type 1)
Status
Active
Enumerated
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Jared Destackelberg PA accepts. To confirm in-network status with your specific health plan, contact Jared Destackelberg PA directly at (352) 622-3360.

Frequently asked

Yes. NPI 1104136399 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (352) 622-3360.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Jared Destackelberg PA is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy363A00000X
Last updated
Enumerated
StatusActive
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