JERRY TAVORNWATTANA – Emergency Medicine Physician, NPI 1093177982
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,232 EMERGENCY MEDICINE in FL
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Provider Addresses for JERRY TAVORNWATTANA
West 8th Street, Springfield, Jacksonville, Duval County, Florida, 32209, United States
JACKSONVILLE, FL 322096511
Phone: (904) 244-3817
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $157.
Total Amount is formed as General ($157) + Research ($0) + Ownership ($0) = $157.
Last reported payment date: 2024-07-23 • Largest payer in this snapshot: ABBVIE INC. ($130).
Total Amount
$157
General + Research + Ownership
Payments
3
Total payment records
General Amount
$157
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $130 |
| CSL Behring | $27 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-08-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190816000322 | I | Emergency Medicine | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 571 | 552 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 292 | 279 | $0 |
| 99291 | Critical care, first 30-74 minutes | 100 | 99 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 88 | 85 | $0 |
Insurance plans in this area (ZIP 32209)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| - | FL | |
| Emergency Medicine | FL | |
| Emergency Medicine | FL | |
| Emergency Medicine | FL | |
| Nurse Practitioner | FL | |
| Emergency Medicine | PR | |
| Emergency Medicine | AR | |
| - | FL |
Reviews
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