Florida Pain Physicians – Interventional Pain Medicine Physician, NPI 1194056283
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Florida Pain Physicians
859 Park Ave Ste 102
Orange Park, FL 320734151
Phone: (904) 449-7246
Fax: (904) 719-7571
Type: Location
206 Ashourian Ave Ste 206
St Augustine, FL 320925107
Phone: (904) 449-7246
Fax: (904) 719-7571
Type: Location
2386 Dunn Ave Ste 111
Jacksonville, FL 322184751
Phone: (904) 449-7246
Fax: (904) 719-7571
Type: Location
105 Whitehall Dr Ste 115
St Augustine, FL 320865269
Phone: (904) 800-7246
Fax: (904) 299-4116
Type: Location
57 Town Ct Ste 121
Palm Coast, FL 321642425
Phone: (904) 593-9503
Fax: (904) 719-7573
Type: Location
PO BOX 1538
PONTE VEDRA BEACH, FL 320041538
Phone: (904) 449-7246
Fax: (904) 719-7571
Type: Mailing
PO BOX 734905
DALLAS, TX 753734905
Phone: (904) 449-7246
Fax: (904) 719-7571
Type: Mailing
4796 HODGES BLVD STE 101
JACKSONVILLE, FL 322242209
Phone: (904) 449-7246
Fax: (904) 719-7571
Type: Location
4796, Hodges Boulevard, Jacksonville, Duval County, Florida, 32224, United States
SUITE 101
JACKSONVILLE, FL 32224
Phone: (904) 449-7246
Fax: (904) 719-7571
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: 2018-11-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (616 days ago).
Enrollment records
1
Earliest due date
2024-09-30
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 |
|---|---|---|---|---|
| O20181127000946 | O | Clinic/Group Practice | FL | 2024-09-30 |
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 32073)
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Reviews
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