Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brian D Tardif, PA

Individual provider Surgical Physician Assistant · NPI 1164719076

Brian D Tardif, PA is a Physician Assistant in Jacksonville, Florida. Qualified in 2011, 15 years ago. Practices with Southeast Orthopedic Specialists LLC, a 145-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
15
Licensed in
FL
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

10475 Centurion Pkwy N Ste 220
Jacksonville, FL 32256-5003
Phone: (904) 634-0640
Fax: (904) 634-0203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9106048 (FL)

Record details

NPI number1164719076
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 30, 2011
Last updated in NPPESMarch 25, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Southeast Orthopedic Specialists Llc — 145 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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