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MRS. ITZEL SANDOVAL-REYNOSO PA-C
NPI 1356011514
Physician Assistant in St Augustine, FL

Active since September 17, 2021PECOS EnrolledAccepts Medicare Assignment
380 PINE LEAF DR, ST AUGUSTINE, FL 32092(904) 707-3147 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 21, 2025, Jun 17, 2025, Apr 4, 2022 and 2 more (5 updates tracked since 2021).

About Mrs. Itzel Sandoval-reynoso Pa-c NPPES

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

MRS. ITZEL SANDOVAL-REYNOSO PA-C (NPI 1356011514) is an individual physician assistant in St Augustine, Florida, licensed in Florida (PA9115077) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, is affiliated with Mayo Clinic, and is a graduate of Nova Southeastern College Of Osteo Medicine (2021).

NPPES Registry Identity

NPI1356011514
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. ITZEL SANDOVAL-REYNOSOCredential: PA-C
Location Address380 PINE LEAF DRSt Augustine, FL 32092-1462
Mailing Address380 Pine Leaf DrSt Augustine, FL 32092-1462 · (904) 707-3147
Phone(904) 707-3147
Sole ProprietorNo
Medical School CMSNova Southeastern College Of Osteo MedicineGraduated 2021
Enumeration DateSeptember 17, 2021
Last NPPES UpdateNovember 21, 20255 updates tracked since enumeration
NPPES CertifiedNovember 21, 2025
✔ NPI 1356011514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA9115077
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.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA9115077 (FL)
380 PINE LEAF DR, St Augustine, FL 32092
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Other Identifiers 1

Medicaid112060700FL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Itzel Sandoval-reynoso Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355749417
PECOS Enrollment IDI20211005001138
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mayo Clinic

Acute Care Hospitals · Jacksonville, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100151
Location4500 San Pablo RdJacksonville, FL 32224 · Duval County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32092 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.

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 Itzel Sandoval-reynoso's NPI number?

The NPI number for Itzel Sandoval-reynoso is 1356011514. It was assigned to this individual provider in the NPPES registry on September 17, 2021.

Where is Itzel Sandoval-reynoso located?

Itzel Sandoval-reynoso practices at 380 Pine Leaf Dr, St Augustine, FL 32092. The listed phone number is (904) 707-3147.

What is Itzel Sandoval-reynoso's specialty?

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

Is Itzel Sandoval-reynoso enrolled in Medicare?

Yes. Itzel Sandoval-reynoso is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Itzel Sandoval-reynoso affiliated with any hospitals?

According to CMS data, Itzel Sandoval-reynoso is affiliated with Mayo Clinic.

When was this NPI record last updated?

The NPPES record for Itzel Sandoval-reynoso was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.