Jack Daubert, M.D., P.A. – Ophthalmology Physician, NPI 1083614366
Ophthalmology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Jack Daubert, M.D., P.A.
11530 SW Village Pkwy #103
Port St Lucie, FL 34987
Phone: (772) 345-1500
Fax: (772) 345-6938
Type: Location
1050, Southeast Monterey Road, Stuart, Martin County, Florida, 34994, United States
STE 104
STUART, FL 349944512
Phone: (772) 283-2020
Fax: (772) 220-9582
Type: Location
7593 W Boynton Beach Blvd Ste 280
Boynton Beach, FL 33437
Phone: (954) 431-2777
Fax: (954) 431-1856
Type: Location
1515 N Flagler Dr Ste 500
West Palm Beach, FL 334013430
Phone: (561) 659-9700
Type: Location
10050 SW Innovation Way Ste 101
Port St Lucie, FL 349872117
Phone: (772) 345-1500
Type: Location
1751 SE Port St Lucie Blvd
Port St Lucie, FL 349525479
Phone: (772) 337-2020
Type: Location
600 University Blvd Ste 100
Jupiter, FL 334582778
Phone: (561) 839-2780
Type: Location
Pop in a Box, 800, Avenida Presidente Juscelino Kubitscheck de Oliveira, Jardim Panorama, São José do Rio Preto, Região Imediata de São José do Rio Preto, Região Geográfica Intermediária de São José do Rio Preto, São Paulo, Southeast Region, 15092-450, Brazil
ORLANDO, FL 328865665
Phone: (772) 283-2020
Fax: (772) 220-9582
Type: Mailing
PO BOX 947665
ATLANTA, GA 303947665
Phone: (772) 283-2020
Fax: (772) 220-9582
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: 2004-02-07
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 |
|---|---|---|---|---|
| O20040207000047 | 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 34987)
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