Individual provider Active NPI

Jessica Defazio, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1003271404
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113468 Issued in FL
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

Updated by the provider on Feb 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217000373 FL Practitioner - Physician Assistant 3173899036 Reassigns benefits to 3 organizations

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
Lyerly Baptist IncGroup PAC ID 9830112226, 72 clinicians

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 Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140

Merit-based Incentive Payment System (MIPS)

Final score
80.78 of 100Reported as group
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

LicenseStateTypeSpecialty
PA9113468FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lyerly Baptist Inc Physician Assistant CurrentSince Sep 5, 2023 Accepting new patients
North Florida Surgeons, PA CurrentSince Apr 18, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 11, 2021 Accepting new patients
North Florida Surgeons, PA CurrentSince Apr 18, 2022 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 11, 2021 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.