MR. OWEN EDMOND JR. MCDONOUGH (PA) – Physician Assistant, NPI 1316919236
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
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Provider Addresses for MR. OWEN EDMOND JR. MCDONOUGH (PA)
San Jose Boulevard, San Jose, Jacksonville, Duval County, Florida, 32217, United States
JACKSONVILLE, FL 322575438
Phone: (904) 262-9444
Fax: (904) 292-2285
Type: Location
2908 CIRCLE RIDGE DR
ORANGE PARK, FL 320655760
Phone: (904) 993-7726
Type: Mailing
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: 2004-11-11
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 |
|---|---|---|---|---|
| I20041111001072 | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 95 | 78 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 60 | 60 | $0 |
| 81003 | Automated urinalysis test | 23 | 18 | $0 |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 21 | 18 | $0 |
| 71046 | X-ray of chest, 2 views | 16 | 16 | $0 |
Insurance plans in this area (ZIP 32257)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | FL |
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