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

Jesse Tyler Crosno, PA

Individual provider Physician Assistant · NPI 1285222315

Jesse Tyler Crosno, PA is a Physician Assistant in Plantation, Florida. Qualified in 2022, 4 years ago. Practices with Sports Medicine Associates of South Florida PA, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2021
Specialties on file
3
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

220 SW 84th Ave Ste 102
Plantation, FL 33324-2729
Phone: (954) 720-1530
Fax: (954) 620-5751
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1600 Town Center Blvd Ste C, Weston, FL 33326-3641 — (954) 389-5900

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9116412 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA9116412 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA9116412 (FL)

Record details

NPI number1285222315
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 5, 2021
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Sports Medicine Associates Of South Florida Pa — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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