TANNELLE MCDOUGLE PA
NPI 1407296197
Physician Assistant - Medical in St Petersburg, FL

Q: What is Tannelle Mcdougle's NPI number?

The NPI number for Tannelle Mcdougle is 1407296197. It was assigned to this individual provider in the NPPES registry on June 27, 2013. The provider is also known as Tannelle Clarke.

Q: What is Tannelle Mcdougle's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: Is Tannelle Mcdougle enrolled in Medicare?

No. Tannelle Mcdougle has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Tannelle Mcdougle was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since June 27, 2013Opted out of Medicare · through Oct 1, 2026

4260 CENTRAL AVE, ST PETERSBURG, FL 33711(727) 339-5496(727) 361-6247 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 5, 2026, Jun 16, 2023, Mar 15, 2023 (3 updates tracked since 2023).

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About Tannelle Mcdougle Pa NPPES

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

TANNELLE MCDOUGLE PA (NPI 1407296197) is an individual medical provider in St Petersburg, Florida, licensed in Florida (PA9107285) and active in the NPI registry since June 2013. She has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1407296197

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameTANNELLE MCDOUGLECredential: PA

Location Address4260 CENTRAL AVESt Petersburg, FL 33711-1140

Mailing Address4260 Central AveSt Petersburg, FL 33711-1140 · (727) 339-5496 · Fax (727) 361-6247

Phone(727) 339-5496

Fax(727) 361-6247

Sole ProprietorYes

Enumeration DateJune 27, 2013

Last NPPES UpdateFebruary 5, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2026

✔ NPI 1407296197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

Taxonomy Code363AM0700X

License✔ Licensed in FL · PA9107285

4260 CENTRAL AVE, St Petersburg, FL 33711

Open in Google Maps ↗

Other Names 1

Former Name (1)Tannelle Clarke

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Tannelle Mcdougle Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2024 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2024

Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

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

ERIC MCDOUGLE P.A.

Physician Assistant (Medical)

4260 CENTRAL AVE
ST PETERSBURG, FL 33711

Pinellas County (727) 339-5496

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 Tannelle Mcdougle's NPI number?

The NPI number for Tannelle Mcdougle is 1407296197. It was assigned to this individual provider in the NPPES registry on June 27, 2013. The provider is also known as Tannelle Clarke.

Where is Tannelle Mcdougle located?

Tannelle Mcdougle practices at 4260 Central Ave, St Petersburg, FL 33711. The listed phone number is (727) 339-5496.

What is Tannelle Mcdougle's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Tannelle Mcdougle enrolled in Medicare?

No. Tannelle Mcdougle has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Tannelle Mcdougle was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.