JACKSONVILLE OUTPATIENT SURGERY CENTER, LLC – Ambulatory Surgical Clinic/Center, NPI 1093276859
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JACKSONVILLE OUTPATIENT SURGERY CENTER, LLC
North Reo Street, Tampa, Hillsborough County, Florida, 33609, United States
TAMPA, FL 336091037
Phone: (813) 549-2134
Type: Mailing
Wells Road, Orange Park, Clay County, Florida, 32073, United States
ORANGE PARK, FL 320732322
Phone: (813) 549-2134
Type: Location
PO BOX 628768
ORLANDO, FL 328628768
Phone: (813) 549-2134
Type: Mailing
1731 WELLS RD SUITE 200
ORANGE PARK, FL 320732322
Phone: (904) 385-2162
Fax: (904) 385-2176
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: 2021-08-30
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 |
|---|---|---|---|---|
| O20210830001198 | O | Ambulatory Surgical Center | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 32 | 25 | $0 |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 26 | 15 | $0 |
| 27279 | Fusion of pelvic joint using imaging guidance | 15 | 13 | $0 |
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 12 | 11 | $0 |
Insurance plans in this area (ZIP 33609)
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