Individual provider Active NPI

Jacob Paul Jensen, DO

  • Surgical Critical Care Physician
  • Hudson, FL
National Provider Identifier
1053808493
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
OS22795 Issued in FL
Practice address
14000 Fivay Rd
Hudson, FL 34667-7103
Phone
(727) 819-2966
Fax
(727) 819-2928
NPI assigned
Apr 20, 2018
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X OS22795 FL Primary
Trauma Surgery Physician 2086S0127X OS22795 FL

Addresses

Primary practice location

14000 Fivay Rd
Hudson, FL 34667-7103

Mailing address

14000 Fivay Rd
Hudson, FL 34667-7103
Phone (727) 819-2966

Other practice location 1

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-1401

Other practice location 2

1350 Hickory St Ste 101
Melbourne, FL 32901-3224
Phone (321) 434-1401

Other identifiers 1

IdentifierTypeStateIssuer
128204400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MO, UT3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250917000167 FL Practitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 3375996606 Reassigns benefits to 4 organizations
I20251211002204 MO Practitioner - General Surgery 3375996606 Reassigns benefits to 1 organization
I20251217002492 UT Practitioner - General Surgery 3375996606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians
Urgent Specialty Associates of Missouri LLCGroup PAC ID 2860874831, 39 clinicians
Florida Trauma Services LLCGroup PAC ID 3971985938, 92 clinicians

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

19600 E 39TH St S
Independence, MO 64057-2301
Phone (816) 698-7000

2316 E Meyer Blvd
Kansas City, MO 64132-1136
Phone (816) 276-4000

3627 University Blvd S
Suite 305
Jacksonville, FL 32216-4294
Phone (904) 596-0760

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS22795FLMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2025 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Aug 28, 2025 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
Florida Trauma Services, LLC Trauma Surgery CurrentSince Dec 1, 2025 Accepting new patients
University of Florida Jacksonville Physicians Inc Surgical Critical Care CurrentSince Aug 28, 2025 Accepting new patients
Orlando Health Medical Group Inc Surgical Critical Care CurrentSince Dec 1, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 28, 2025 Accepting new patients
Urgent Specialty Associates of Missouri LLC Surgical Critical Care CurrentSince Nov 1, 2025 Accepting new patients
Urgent Specialty Associates of Utah PLLC Surgical Critical Care CurrentSince Nov 1, 2025 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

3627 University Blvd S
Ste 305
Jacksonville, FL 32216
Phone (214) 712-2444

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1887 Kingsley Ave
Ste 1900
Orange Park, FL 32073
Phone (904) 272-9981

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

Interoperability endpoints

  • Direct secure messaging: jjensen816519@direct.shands.ufl.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1053808493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-819-2966",
            "fax_number": "727-819-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-819-2966",
            "fax_number": "727-819-2928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-434-1401",
            "fax_number": "321-434-1667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Hickory St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-434-1401",
            "fax_number": "321-434-1667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JACOB",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "OS22795",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "OS22795",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128204400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.