CORY GRANT PETERS (PA) – Surgical Physician Assistant, NPI 1144395708
Surgical Physician Assistant
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NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for CORY GRANT PETERS (PA)
2 Shircliff Way Ste 605
Jacksonville, FL 322044762
Phone: (904) 634-0640
Type: Location
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 320826600
Phone: (904) 634-0264
Fax: (904) 634-0203
Type: Location
1690 US Highway 1 S Ste F
St Augustine, FL 320846024
Phone: (904) 634-0640
Fax: (904) 634-0203
Type: Location
216 Southpark Cir E Ste 216
St Augustine, FL 320865135
Phone: (904) 634-0640
Fax: (904) 634-0203
Type: Location
4565 US Highway 17 Ste 200
Fleming Island, FL 320034823
Phone: (904) 634-0640
Fax: (904) 634-0203
Type: Location
15255 Max Legget Pkwy Ste 5300
Jacksonville, FL 322187274
Phone: (904) 634-0640
Fax: (904) 634-0203
Type: Location
3055 County Road 210 W Ste 110
St Johns, FL 322597001
Phone: (904) 634-0640
Type: Location
2627 Riverside Ave Ste 300
Jacksonville, FL 322044717
Phone: (904) 634-0640
Fax: (907) 634-0203
Type: Location
4500 San Pablo Rd S
Jacksonville, FL 322241865
Phone: (904) 953-2000
Type: Location
6800 SOUTHPOINT PKWY STE 300
JACKSONVILLE, FL 322168203
Phone: (904) 634-0640
Fax: (904) 634-0203
Type: Mailing
6500, Bowden Road, Greenfield Manor, Jacksonville, Duval County, Florida, 32216, United States
SUITE 103
JACKSONVILLE, FL 322168070
Phone: (904) 634-0640
Fax: (904) 634-0203
Type: Mailing
10475, Centurion Parkway North, Deerwood Park, Jacksonville, Duval County, Florida, 32256, United States
SUITE 220
JACKSONVILLE, FL 32256
Phone: (904) 634-0640
Fax: (904) 634-0203
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2012-10-11
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 |
|---|---|---|---|---|
| I20121011000685 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 6,182 | 335 | $0 |
| 20600 | Aspiration and/or injection of fluid from small joint | 1,122 | 317 | $0 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 337 | 94 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 329 | 285 | $0 |
| 20605 | Aspiration and/or injection of fluid from medium joint | 147 | 74 | $0 |
Insurance plans in this area (ZIP 32204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | FL | |
| G A S T R O E N T E R O L O G Y | FL | |
| Orthopedic Surgery | FL | |
| Internal Medicine | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Certified Registered Nurse Anesthetist (Crna) | FL |
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