Jamison Dicus, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9106955 Issued in FL

Practice address

7370 College Pkwy Ste 206
Fort Myers, FL 33907-5558

Phone

(512) 730-3056

Fax

(888) 730-1925

NPI assigned

Oct 29, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fort Myers Primary Care and Wellness LLCGroup PAC ID 6800244484, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Hni Hospital Services of Florida, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Panama City, FL
  • NPI 1144851411
  Medicare reassignment
• Hni Medical Services of Florida, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1679048284
  Medicare reassignment
• Pai Participant 1 LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1093371312

  FL

  Medicare reassignment
• Fort Myers Primary Care and Wellness LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1760164800
  Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1013261197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 S CLEVELAND AVE STE 56",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073871",
            "telephone_number": "239-344-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 COLLEGE PKWY STE 206",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075558",
            "telephone_number": "512-730-3056",
            "fax_number": "888-730-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICUS",
        "first_name": "JAMISON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-29",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9106955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9106955",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Austin",
            "affiliation": "Y",
            "affiliationName": "HNI Medical Services of Florida, LLC",
            "address_1": "7500 Rialto Blvd Ste 1-140",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787358534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frank Peter Diblase, D.C
• Dicenzo Enterprises Incorporated
• Maurice H Dick, MD
• Mary Elizabeth Ann Dickout, B.A.,CPRP
• Pamela A Dicristofalo, PHARMD
• Robert A Didonato, MD
• Kathryn Diep, LCSW
• Alec James Dierksheide, DPM
• Hannah Dierksheide
• Emilie Victoria Digby, CRNA

• Surgical Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.

Verify at the official NPI Registry.