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

Jay Raleigh Humphrey, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1497977235

Jay Raleigh Humphrey, PHYSICIANASSISTANT is a Physician Assistant in Venice, Florida. Qualified in 2006, 20 years ago. Practices with Millennium Physician Group LLC, a 970-clinician group and accepts Medicare assignment. Licensed in Connecticut and Florida.

Years since qualifying
20
Licensed in
CT, FL
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

8036 S Tamiami Trl
Venice, FL 34293-5113
Phone: (941) 244-4300
Fax: (941) 244-4380
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9116008 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 002111 (CT)

Record details

NPI number1497977235
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedMay 2, 2007
Last updated in NPPESAugust 23, 2024
Certification dateAugust 21, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Millennium Physician Group Llc — 970 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations17 on file with Medicare

Other providers in Venice