Unknown Individual – Family Medicine Physician, NPI 1013985035
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
6520 FORT CAROLINE RD
JACKSONVILLE, FL 322772044
Phone: (904) 745-3618
Fax: (904) 722-4271
Type: Mailing
4565 US HIGHWAY 17 STE 106
FLEMING ISLAND, FL 320034822
Phone: (904) 269-4559
Fax: (904) 269-4597
Type: Location
847, Park Avenue, Orange Park, Clay County, Florida, 32073, United States
ORANGE PARK, FL 320734117
Phone: (904) 264-4541
Fax: (904) 278-2709
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $483.
Total Amount is formed as General ($483) + Research ($0) + Ownership ($0) = $483.
Last reported payment date: 2023-06-23 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($159).
Total Amount
$483
General + Research + Ownership
Payments
22
Total payment records
General Amount
$483
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $159 |
| Novo Nordisk Inc | $64 |
| Lilly USA, LLC | $35 |
| Bayer Healthcare Pharmaceuticals Inc. | $33 |
| Merck Sharp & Dohme LLC | $32 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 150 | 105 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 142 | 92 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 77 | 50 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 51 | 51 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 16 | 16 | $0 |
Insurance plans in this area (ZIP 32277)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL |
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