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

Jacob Ryan Gardner, PA

Individual provider Medical Physician Assistant · NPI 1528821642

Jacob Ryan Gardner, PA is a Physician Assistant in Clearwater, Florida. Qualified in 2024, 2 years ago. Practices with Metropolitan Charities Inc, a 17-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
2
Licensed in
FL
In the registry since
2024
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

18167 US Highway 19 N Ste 150
Clearwater, FL 33764-6566
Phone: (727) 321-3854
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4747 Us Highway 19, New Port Richey, FL 34652-4945 — (727) 321-3854

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9118395 (FL)

Record details

NPI number1528821642
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 1, 2024
Last updated in NPPESMarch 27, 2024
Certification dateMarch 27, 2024
Mailing address701 94th Ave N Ste 250, St Petersburg, FL 33702-2448

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Metropolitan Charities Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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