DAVID L TENNISWOOD (MD) – Surgery Physician, NPI 1184674624

DAVID L TENNISWOOD (MD) is a healthcare provider. based in Jacksonville, Florida. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. 0428049 (KS). The NPI Number for DAVID L TENNISWOOD (MD) is 1184674624

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
DAVID L TENNISWOOD (MD)
NPI
1184674624
Phone
(904) 450-6014
Address
4205 BELFORT RD STE 4015
Enumeration Date
12 May 2006
Last Update Date
3 March 2020

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8504754620
Graduation Year
1992 (34 years ago)
PAC ID
1456424738
Group Practice PAC ID
5799763074
Professional Enrollment ID
I20110311000536
Address ID
FL325032601PE4451XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

2,163 GENERAL SURGERY in FL

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Provider Addresses for DAVID L TENNISWOOD (MD)

  • 4015, Belfort Road, Jacksonville, Duval County, Florida, 32216, United States

    JACKSONVILLE, FL 322163623

    Phone: (904) 450-6014

    Fax: (904) 450-6401

    Type: Mailing

  • 619, North Cove Boulevard, Panama City, Bay County, Florida, 32401, United States

    PANAMA CITY, FL 324013642

    Phone: (850) 913-6960

    Fax: (850) 913-6961

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $5,397.

Total Amount is formed as General ($5,397) + Research ($0) + Ownership ($0) = $5,397.

Last reported payment date: 2024-02-28 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($5,164).

Total Amount

$5,397

General + Research + Ownership

Payments

12

Total payment records

General Amount

$5,397

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-28

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2011-03-11

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110311000536IGeneral SurgeryFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes14396$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes7473$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes5643$0
99239Hospital discharge day management, more than 30 minutes4949$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes3930$0
View full utilization report →

Insurance plans in this area (ZIP 32216)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799763074View full group profile

Reviews

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Frequently asked questions

How is DAVID L TENNISWOOD (MD) identified in CMS data?
CMS-hosted NPPES data lists DAVID L TENNISWOOD (MD) with NPI 1184674624.
Is DAVID L TENNISWOOD (MD) still practicing?
DAVID L TENNISWOOD (MD) is currently listed as active in the public NPI registry.
What is DAVID L TENNISWOOD (MD)'s specialty?
The listing groups DAVID L TENNISWOOD (MD) with Surgery Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DAVID L TENNISWOOD (MD)?
DAVID L TENNISWOOD (MD)'s geographic hint is Jacksonville, Florida in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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