PAUL PETTIT (MD) – Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician, NPI 1689663304

PAUL PETTIT (MD) is a healthcare provider. based in Jacksonville, Florida. specializing in Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician. They hold the professional credentials MD. They hold a License No. ME48610 (FL). The NPI Number for PAUL PETTIT (MD) is 1689663304

Main info

Male
49 Years Of Experience
Accepts Medicare Assignment
Name
PAUL PETTIT (MD)
NPI
1689663304
Phone
Not provided
Address
4500 SAN PABLO RD S
Enumeration Date
15 October 2005
Last Update Date
24 March 2021

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9049532000
Graduation Year
1977 (49 years ago)
PAC ID
9537225289
Group Practice PAC ID
5698689297
Professional Enrollment ID
I20090304000231
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for PAUL PETTIT (MD)

  • San Pablo Road South, San Pablo, Jacksonville, Duval County, Florida, 32224, United States

    JACKSONVILLE, FL 322241865

    Phone:

    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 8 Open Payments records for all available years, with a total value of $18,494.

Total Amount is formed as General ($18,494) + Research ($0) + Ownership ($0) = $18,494.

Last reported payment date: 2024-07-11 • Largest payer in this snapshot: Caldera Medical, Inc ($14,600).

Total Amount

$18,494

General + Research + Ownership

Payments

8

Total payment records

General Amount

$18,494

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-11

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32224)

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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: 5698689297View full group profile
NameSpecialtyState
Physician AssistantFL
G A S T R O E N T E R O L O G YFL
Orthopedic SurgeryFL
Internal MedicineFL
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL
Physician AssistantFL
Nurse PractitionerFL
-FL
Certified Registered Nurse Anesthetist (Crna)FL

Reviews

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Frequently asked questions

Where can patients find PAUL PETTIT (MD)'s NPI?
You can confirm PAUL PETTIT (MD) with NPI 1689663304; it appears in the national provider directory.
Is PAUL PETTIT (MD) active in the national directory?
PAUL PETTIT (MD)'s public NPI profile is in an active state.
Does PAUL PETTIT (MD) list a primary specialty?
If you are matching referrals, note Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician for PAUL PETTIT (MD). Clinical services aligned with this taxonomy classification.
Where is PAUL PETTIT (MD)'s primary listing?
We display Jacksonville, Florida because that is what the record indicates for PAUL PETTIT (MD).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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