Jacob Renuart, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME168099 Issued in FL

Practice address

4611 US Highway 17 Ste 2
Fleming Island, FL 32003-8248

Phone

(904) 264-4333

Fax

(904) 264-4301

NPI assigned

May 17, 2021

Last updated

Jan 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacobrenuart@ip-fl1.direct.office.nextgen.com

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.

• Shelly L. Hall M.D., P.a.

  dba Island Pediatrics

  • Pediatrics Physician
  • Orange Park, FL
  • NPI 1841231610
  NPD (past)

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1053985861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 US HIGHWAY 17 STE 2",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 US HIGHWAY 17 STE 2",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038248",
            "telephone_number": "904-264-4333",
            "fax_number": "904-264-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENUART",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME168099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raychel Lee Raymer
• Maria Magdalena Ready, PA
• Sathavaram Aravind Reddy, M.D.
• Savannah Reimer
• Mikayla Reneau
• Judith G Rewis, ARNP
• Madeline E. Rice
• Sasha Rich
• Richard D Curtis M.D., P.a.
• Lindsay Richmond, APRN

• Pediatrics Physician in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.