JAMES E. PATRICK (PA-C) – Surgical Physician Assistant, NPI 1689663528
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JAMES E. PATRICK (PA-C)
32507, Hawks Lake Lane, Sorrento, Lake County, Florida, 32776, United States
SORRENTO, FL 327767738
Phone: (407) 791-1456
Type: Location
30 PROSPECT AVE
HACKENSACK, NJ 076011915
Phone: (551) 996-5430
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: 2022-06-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20031210000392 | I | Physician Assistant | FL | TBD |
| I20151005002128 | I | Physician Assistant | ND | TBD |
| I20180403000716 | I | Physician Assistant | NY | TBD |
| I20220613002050 | I | Physician Assistant | NJ | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32776)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | ND | |
| Nurse Practitioner | ND | |
| Internal Medicine, Hospitalist | OH | |
| Nurse Practitioner | ND | |
| Nurse Practitioner, Certified Registered Nurse Anesthetist (Crna) | ND | |
| - | ND | |
| Nurse Practitioner | ND | |
| Family Practice, Hospitalist, Family Practice, Hospitalist | FL | |
| - | SD |
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