ST VINCENTS PATHOLOGY ASSOCIATES PA – Anatomic Pathology & Clinical Pathology Physician, NPI 1114074200
Anatomic Pathology & Clinical Pathology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ST VINCENTS PATHOLOGY ASSOCIATES PA
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 328144333
Phone: (407) 422-9831
Fax: (855) 671-4753
Type: Mailing
Saint Vincent's Medical Center Riverside, 1, Shircliff Way, Riverside, Jacksonville, Duval County, Florida, 32204, United States
DEPT OF PATHOLOGY
JACKSONVILLE, FL 322044748
Phone: (904) 308-7300
Fax: (904) 308-2970
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: 2005-06-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-07-31 (318 days ago).
Enrollment records
1
Earliest due date
2025-07-31
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 |
|---|---|---|---|---|
| O20050618000097 | O | Clinic/Group Practice | FL | 2025-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 32814)
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