Active NPI
Jessica Defazio, PA-C
- Physician Assistant
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9113468
- Practice address
- 836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340 - Phone
- (904) 388-6518
- Fax
- (904) 384-1005
- NPI assigned
- Dec 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9113468 | FL | Primary |
Addresses
Primary practice location
836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340
Mailing address
PO Box 746647
Atlanta, GA 30374-6647
Phone (904) 202-2092
Other practice location 1
1370 13th Ave S Ste 118
Jacksonville Beach, FL 32250-3206
Phone (904) 388-6518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
836 Prudential Dr
Suite 1400
Jacksonville, FL 32207-8340
Phone (904) 388-6518
Hospital & facility affiliations
- Baptist Health Medical Center - Jacksonville
- Baptist Medical Center Beaches
- Baptist Medical Center - Nassau
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.78 of 100
- Quality
- 65.03
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.91
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9113468 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lyerly Baptist Inc | Physician Assistant | Current | Accepting new patients |
| North Florida Surgeons, PA | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| North Florida Surgeons, PA | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians Inc | Current | Accepting new patients |
Locations
1747 Baptist Clay Dr
Ste 240
Fleming Island, FL 32003
Phone (904) 214-8161
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223
800 Prudential Dr
Ste 1100
Jacksonville, FL 32207
Phone (904) 338-6518
836 Prudential Dr
Ste 1400
Jacksonville, FL 32207
Phone (904) 396-0000
14546 Old St Augustine Rd
Ste 407
Jacksonville, FL 32258
Phone (904) 262-3372
11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937
1370 13th Ave S
Ste 118
Jacksonville Beach, FL 32250
Phone (904) 247-1456
1370 13th Ave S
Ste 215
Jax Bch, FL 32250
Phone (904) 249-1041
Interoperability endpoints
- jminor58593@baptisthealthsystemjacksonville.direct-ci.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Neurological Surgery Physician
- Jacksonville, FL
- NPI 1851347801
Physician Assistant
-
- Surgery Physician
- Jacksonville, FL
- NPI 1912953290
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
-
- Orthopaedic Surgery Physician
- Gulf Breeze, FL
- NPI 1871442053
-
- Surgery Physician
- Jacksonville, FL
- NPI 1588824858
-
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fernandina Beach, FL
- NPI 1518024462
-
- General Acute Care Hospital
- Jacksonville Beach, FL
- NPI 1821155912
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1003271404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746647",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746647",
"telephone_number": "904-202-2092",
"fax_number": "904-376-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "836 PRUDENTIAL DR STE 1400",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078340",
"telephone_number": "904-388-6518",
"fax_number": "904-384-1005"
}
],
"practiceLocations": [
{
"address_1": "1370 13th Ave S Ste 118",
"address_purpose": "LOCATION",
"city": "Jacksonville Beach",
"state": "FL",
"postal_code": "322503206",
"country_code": "US",
"telephone_number": "904-388-6518",
"fax_number": "904-388-1005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEFAZIO",
"first_name": "JESSICA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-30",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9113468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.