MR. JACK JOSEPH CRISTIANO JR. PA-C
NPI 1356939409
Physician Assistant - Surgical in Fort Lauderdale, FL

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

Active since January 05, 2021PECOS EnrolledAccepts Medicare Assignment

1625 SE 3RD AVE STE 300, FORT LAUDERDALE, FL 33316(954) 355-4665(954) 355-4881 Get Directions Write a Review

NPPES record last updated: April 3, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 3, 2024, Mar 28, 2023, Sep 27, 2022 and 3 more (6 updates tracked since 2021).

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About Mr. Jack Joseph Cristiano Jr. Pa-c NPPES

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

MR. JACK JOSEPH CRISTIANO JR. PA-C (NPI 1356939409) is an individual surgical provider in Fort Lauderdale, Florida, licensed in Florida (9116364) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS, is affiliated with Cheyenne Regional Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1356939409

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. JACK JOSEPH CRISTIANO JR.Credential: PA-C

Location Address1625 SE 3RD AVE STE 300Fort Lauderdale, FL 33316-2521

Mailing Address1700 Nw 49th St Ste 125Fort Lauderdale, FL 33309-3750 · (954) 355-4665 · Fax (954) 355-4881

Phone(954) 355-4665

Fax(954) 355-4881

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJanuary 5, 2021

Last NPPES UpdateApril 3, 20246 updates tracked since enumeration

NPPES CertifiedApril 3, 2024

✔ NPI 1356939409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · 9116364

1625 SE 3RD AVE STE 300, Fort Lauderdale, FL 33316

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming, Medica, UnitedHealthcare.Insurance ›

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

Mr. Jack Joseph Cristiano Jr. 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 ID9739555657

PECOS Enrollment IDI20250303000085

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.

Cheyenne Regional Medical Center

Acute Care Hospitals · Cheyenne, WY

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number530014

Location214 East 23rd StreetCheyenne, WY 82001 · Laramie County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 17

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

KAREN CALCANO P.A.

Physician Assistant (Surgical)