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

Jaclyn M Nietzer, PA

Individual provider Surgical Physician Assistant · NPI 1417290586

Jaclyn M Nietzer, PA is a Physician Assistant in Orlando, Florida. Qualified in 2012, 14 years ago. Practices with Orlando Health Medical Group Inc, a 2,137-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
14
Licensed in
FL
In the registry since
2013
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

1222 S Orange Ave
Orlando, FL 32806-1215
Phone: (321) 841-6444
Fax: (407) 650-1307
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5151 N 9th Ave, Pensacola, FL 32504-8721 — (850) 416-4970

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9107172 (FL)

Record details

NPI number1417290586
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 27, 2013
Last updated in NPPESJuly 27, 2022
Certification dateJuly 27, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Orlando Health Medical Group Inc — 2137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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