DR. LARISSA SARAH BUCCOLO (M.D.) – Family Medicine Physician, NPI 1598747925

DR. LARISSA SARAH BUCCOLO (M.D.) is a healthcare provider. based in Jacksonville, Florida. specializing in FAMILY PRACTICE, EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. ME103556 (FL). The NPI Number for DR. LARISSA SARAH BUCCOLO (M.D.) is 1598747925

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. LARISSA SARAH BUCCOLO (M.D.)
NPI
1598747925
Phone
(904) 396-5682
Address
820 PRUDENTIAL DR
Enumeration Date
21 November 2005
Last Update Date
5 November 2025

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9042023300
Graduation Year
2002 (24 years ago)
PAC ID
9739362948
Group Practice PAC ID
5092801647
Professional Enrollment ID
I20110325000411
Address ID
FL322078350JA841XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

6,722 FAMILY PRACTICE in FL

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Provider Addresses for DR. LARISSA SARAH BUCCOLO (M.D.)

  • 820, Prudential Drive, Jacksonville, Duval County, Florida, 32207, United States

    STE 713

    JACKSONVILLE, FL 322078210

    Phone: (904) 396-5682

    Fax: (904) 346-0864

    Type: Mailing

  • 841 Prudential Dr Ste 180

    Jacksonville, FL 322078350

    Phone: (904) 202-3300

    Fax: (904) 202-3310

    Type: Location

  • 820 PRUDENTIAL DR STE 713

    JACKSONVILLE, FL 322078209

    Phone: (904) 396-5682

    Fax: (904) 346-0864

    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: 2011-03-25

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
I20110325000411IFamily PracticeFLTBD

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
99284Emergency department visit with moderate level of medical decision making7171$0
99285Emergency department visit with high level of medical decision making6160$0
View full utilization report →

Insurance plans in this area (ZIP 32207)

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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: 5092801647View full group profile
NameSpecialtyState
-FL
Family Practice, Emergency MedicineFL
Family PracticeFL
Family Practice, Emergency MedicineFL
-PA
Emergency Medicine, Family PracticeFL
-UT
-FL
Family Practice, Emergency MedicineFL
-FL

Reviews

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Frequently asked questions

What NPI should I save for DR. LARISSA SARAH BUCCOLO (M.D.)?
Save NPI 1598747925 if you need a stable reference for DR. LARISSA SARAH BUCCOLO (M.D.).
Is DR. LARISSA SARAH BUCCOLO (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does DR. LARISSA SARAH BUCCOLO (M.D.) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for DR. LARISSA SARAH BUCCOLO (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. LARISSA SARAH BUCCOLO (M.D.)?
The page summarizes Jacksonville, Florida for DR. LARISSA SARAH BUCCOLO (M.D.); expand the address list for detail.
What if Jacksonville, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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