THE DOCTORS CENTER PA – Family Medicine Physician, NPI 1053366880
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for THE DOCTORS CENTER PA
9857 OLD SAINT AUGUSTINE RD STE 1
JACKSONVILLE, FL 322578821
Phone: (904) 861-1900
Fax: (904) 292-9684
Type: Mailing
5915 Normandy Blvd
Jacksonville, FL 322056200
Phone: (904) 861-1900
Fax: (904) 388-3169
Type: Location
7824 Lake Underhill Rd Ste B
Orlando, FL 328228201
Phone: (407) 281-0470
Type: Location
280 Wekiva Springs Rd Ste 1000
Longwood, FL 327796098
Phone: (407) 788-2273
Type: Location
595 Oak Commons Blvd Ste A
Kissimmee, FL 347414211
Phone: (321) 249-6954
Type: Location
712 53rd Ave E Ste B
Bradenton, FL 342035827
Phone: (941) 755-2456
Type: Location
4160 University Blvd S
Jacksonville, FL 322164317
Phone: (904) 861-1900
Fax: (904) 292-9264
Type: Location
20803 Biscayne Blvd Ste 202
Aventura, FL 331801429
Phone: (305) 931-9002
Fax: (305) 692-9176
Type: Location
2255 Dunn Ave Ste 100
Jacksonville, FL 322184739
Phone: (904) 861-1900
Fax: (904) 751-5481
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: 2004-01-16
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 |
|---|---|---|---|---|
| O20040116000189 | 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 32257)
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