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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHEILA R DICKERMAN PA
NPI 1104119874
Physician Assistant in Summerfield, FL

Active since May 27, 2011PECOS Enrolled
17136 SE 109TH TERRACE RD STE 4, SUMMERFIELD, FL 34491(352) 320-6154 Get Directions Write a Review

NPPES record last updated: September 18, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 18, 2026, Aug 16, 2023, May 17, 2023 and 3 more (6 updates tracked since 2017).

About Sheila R Dickerman Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHEILA R DICKERMAN PA (NPI 1104119874) is an individual physician assistant in Summerfield, Florida, licensed in Florida (PA9105799) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104119874
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSHEILA R DICKERMANCredential: PA
Location Address17136 SE 109TH TERRACE RD STE 4Summerfield, FL 34491-9032
Mailing Address2546 Middleton Grove DrBrandon, FL 33511-4784 · (813) 781-5233
Phone(352) 320-6154
Sole ProprietorNo
Enumeration DateMay 27, 2011
Last NPPES UpdateSeptember 18, 20266 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2026
✔ NPI 1104119874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in FL · PA9105799✔ Licensed in ME · PA2079
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
17136 SE 109TH TERRACE RD STE 4, Summerfield, FL 34491
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Other Names 1

Former Name (1)Sheila Obradovich Pa

Other Identifiers 1

Medicaid013054000FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sheila R Dickerman Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34491 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ETHAN ANTHONY REULET
Nurse Practitioner
17136 SE 109TH TERRACE RD STE 4
SUMMERFIELD, FL 34491
Marion County (352) 320-6154
AVECINA MEDICAL, PA
Clinic/Center (Urgent Care)
17136 SE 109TH TERRACE RD STE 4
SUMMERFIELD, FL 34491
Marion County (904) 230-6898

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sheila Dickerman's NPI number?

The NPI number for Sheila Dickerman is 1104119874. It was assigned to this individual provider in the NPPES registry on May 27, 2011. The provider is also known as Sheila Obradovich PA.

Where is Sheila Dickerman located?

Sheila Dickerman practices at 17136 SE 109th Terrace Rd Ste 4, Summerfield, FL 34491. The listed phone number is (352) 320-6154.

What is Sheila Dickerman's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Sheila Dickerman enrolled in Medicare?

Yes. Sheila Dickerman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sheila Dickerman was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.