JESSICA MARIE HOLLER MD
NPI 1376247692
Student in an Organized Health Care Education/Training Program in Tampa, FL

Q: What is Jessica Holler's NPI number?

The NPI number for Jessica Holler is 1376247692. It was assigned to this individual provider in the NPPES registry on March 29, 2023.

Q: What is Jessica Holler's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Holler was last updated on March 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since March 29, 2023PECOS Enrolled

17 DAVIS BLVD STE 308, TAMPA, FL 33606(813) 974-2201 Get Directions Write a Review

NPPES record last updated: March 29, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Jessica Marie Holler Md NPPES

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

JESSICA MARIE HOLLER MD (NPI 1376247692) is an individual student in an organized health care education/training program in Tampa, Florida and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1376247692

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJESSICA MARIE HOLLERCredential: MD

Location Address17 DAVIS BLVD STE 308Tampa, FL 33606-3438

Mailing Address17 Davis Blvd Ste 308Tampa, FL 33606-3438

Phone(813) 974-2201

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateMarch 29, 2023

NPPES CertifiedMarch 29, 2023

✔ NPI 1376247692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

17 DAVIS BLVD STE 308, Tampa, FL 33606

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Marie Holler Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3274097001

PECOS Enrollment IDI20260713004293

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.

Medicare Billing Reassignment

Medicare enrollment records show Jessica Holler reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Medical Service Association Inc

Same address

Pediatrics

17 DAVIS BLVD, 1ST FLOOR
Tampa, FL 33606

Reassigned Medicare billing, Florida enrollment
1,079 clinicians in this Medicare group

NPI 1821038761 (813) 259-8700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

MARISOL GOMEZ MD

Student in an Organized Health Care Education/Training Program