NPIMap

Individual provider Active NPI

Patrick J Harris, D O

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1063525350
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS-0008101 Issued in FL
Practice address
270 Plaza Blvd Ste B5-B6
Saint Augustine, FL 32086-9305
Phone
(904) 819-5150
Fax
(904) 819-5152
NPI assigned
Aug 17, 2006
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS-0008101 FL Primary

Addresses

Primary practice location

270 Plaza Blvd Ste B5-B6
Saint Augustine, FL 32086-9305

Mailing address

PO Box 740861
Atlanta, GA 30374-0861
Phone (904) 819-9453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051118000566 FL Practitioner - Family Practice 2365461605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

270 Plaza Blvd
Suite B5 B6
Saint Augustine, FL 32086-9305
Phone (904) 819-5150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS-0008101FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Professional Health Care Services, Inc. Family Medicine CurrentSince Aug 5, 2024 Accepting new patients
Flagler Professional Health Care Services, Inc. CurrentSince Aug 5, 2024 Accepting new patients
Villages Regional Hospital Physician Services LLC CurrentSince Jul 19, 2025 Accepting new patients
Flagler Professional Health Care Services, Inc. Family Medicine Past Accepting new patients
Georgia Department of Human Resources Past Accepting new patients
Welaka Clinic Inc Family Medicine Past Accepting new patients
Ellen L Talos MD PA Family Medicine Past Accepting new patients

Locations

120 Palencia Village Dr
Saint Augustine, FL 32095
Phone (904) 819-3200

120 Palencia Village Dr
Ste 107
Saint Augustine, FL 32095
Phone (904) 819-3200

270 Plaza Blvd
Ste B5B6
Saint Augustine, FL 32086
Phone (904) 819-5150

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Interoperability endpoints

  • Direct secure messaging: pharris741044@direct.shands.ufl.edu

Organizations & group practices 7

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1063525350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740861",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740861",
            "telephone_number": "904-819-9453",
            "fax_number": "904-819-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 PLAZA BLVD STE B5-B6",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320869305",
            "telephone_number": "904-819-5150",
            "fax_number": "904-819-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-06-24",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS-0008101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.