Reliance Primary & Urgent Care – Internal Medicine Physician, NPI 1023522315
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Reliance Primary & Urgent Care
8833 PERIMETER PARK BLVD STE 503
JACKSONVILLE, FL 322161110
Phone: (904) 687-1055
Fax: (904) 687-2141
Type: Location
7163 E Mount Vernon St
Glen Saint Mary, FL 320405085
Phone: (904) 687-1055
Fax: (904) 687-2141
Type: Location
Heron Landing Road, St. Johns County, Florida, United States
SAINT JOHNS, FL 322597074
Phone: (321) 506-3925
Type: Mailing
630, Jacksonville Drive, Jacksonville Beach, Duval County, Florida, 32250, United States
JACKSONVILLE BEACH, FL 322503814
Phone: (904) 435-0799
Fax: (904) 435-0797
Type: Location
2220 COUNTY ROAD 210 W STE 108
PMB 257
ST JOHNS, FL 322594060
Phone: (321) 506-3925
Type: Mailing
2220 COUNTY RD 210 WEST
STE 108, PMB 257
JACKSONVILLE, FL 322594060
Phone: (321) 506-3925
Type: Mailing
7163 E MOUNT VERNON ST
GLEN SAINT MARY, FL 320405085
Phone: (904) 687-1055
Fax: (904) 687-2141
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: 2021-10-01
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 |
|---|---|---|---|---|
| O20211001002923 | O | Clinic/Group Practice | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32216)
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