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

Mr. Jon P Boettger, PA

Individual provider Physician Assistant · NPI 1982916888

Mr. Jon P Boettger, PA is a Physician Assistant in Tampa, Florida. Qualified in 2010, 16 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida and Texas.

Years since qualifying
16
Licensed in
FL, TX
In the registry since
2010
Specialties on file
2
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

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone: (813) 745-4673
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4450 Sojourn Dr Ste 200, Addison, TX 75001 — (972) 733-0014
  • 6001 Kyle Pkwy Ste 101, Kyle, TX 78640 — (512) 294-1771

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9105512 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA12179 (TX)

Record details

NPI number1982916888
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 8, 2010
Last updated in NPPESMay 6, 2022
Certification dateMay 6, 2022
Mailing addressPo Box 198441, Atlanta, GA 30384-8441

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc — 1135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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