JESSICA DEKLAVON
NPI 1407505779
Physician Assistant in Hollywood, FL

Q: What is Jessica Deklavon's NPI number?

The NPI number for Jessica Deklavon is 1407505779. It was assigned to this individual provider in the NPPES registry on March 22, 2022.

Q: What is Jessica Deklavon's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jessica Deklavon was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 March 22, 2022PECOS EnrolledAccepts Medicare Assignment

1150 N 35TH AVE STE 130, HOLLYWOOD, FL 33021(954) 265-7700(954) 276-0021 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jessica Deklavon NPPES

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

JESSICA DEKLAVON (NPI 1407505779) is an individual physician assistant in Hollywood, Florida, licensed in Florida (PA9115460) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, is affiliated with Memorial Regional Hospital, and maintains a secondary practice location in Miramar.

NPPES Registry Identity

NPI1407505779

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJESSICA DEKLAVON

Location Address1150 N 35TH AVE STE 130Hollywood, FL 33021-5424

Mailing Address1150 N 35th Ave Ste 130Hollywood, FL 33021-5424 · (954) 265-7700

Phone(954) 265-7700

Fax(954) 276-0021

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateMarch 22, 2022

Last NPPES UpdateApril 27, 2026

NPPES CertifiedApril 27, 2026

✔ NPI 1407505779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in FL · PA9115460

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.

1150 N 35TH AVE STE 130, Hollywood, FL 33021

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Secondary Practice Location 1

Location 11951 SW 172nd Ave Ste 405Miramar, FL 33029-5614 · Phone (954) 265-7700 · Fax (954) 276-0021

Other Identifiers 1

OtherPA9115460FL · Department Of Health

Accepted Insurance

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

Jessica Deklavon 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 ID3476921966

PECOS Enrollment IDI20221114002487

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 2

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

Memorial Regional Hospital

Acute Care Hospitals · Hollywood, FL

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100038

Location3501 Johnson StHollywood, FL 33021 · Broward County

Emergency services Birthing friendly

Memorial Hospital Pembroke

Acute Care Hospitals · Pembroke Pines, FL

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100230

Location7800 Sheridan StPembroke Pines, FL 33024 · Broward County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33021 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

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$73.00 typical visit price

range $18.44 – $144.68

Typical copayment $18.25 (range $4.61 – $36.17)

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.

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Other Providers at the Same Location NPPES 8

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

KELSEY PARRA PA

Physician Assistant