Individual provider Active NPI

Nicholas John Bremer, M.D.

  • Pain Medicine Physician
  • Fernandina Beach, FL
National Provider Identifier
1083778468
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
ME126043 Issued in FL
Practice address
1699 S 14TH St Ste 16
Fernandina Beach, FL 32034-1965
Phone
(904) 223-3321
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X ME126043 FL Primary

Addresses

Primary practice location

1699 S 14TH St Ste 16
Fernandina Beach, FL 32034-1965

Mailing address

5191 First Coast Tech Pkwy
3Rd Floor
Jacksonville, FL 32224
Phone (904) 223-3321

Other practice location 1

15255 Max Leggett Pkwy Ste 5500
Jacksonville, FL 32218-7273
Phone (904) 223-3321

Other practice location 2

5191 First Coast Tech Pkwy
3rd Floor
Jacksonville, FL 32224-0609
Phone (904) 223-3321

Other identifiers 1

IdentifierTypeStateIssuer
108108900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20160510000463 WV Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 9638468945 Reassigns benefits to 1 organization
I20200921001071 FL Practitioner - Pain ManagementPractitioner - Anesthesiology 9638468945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Vermont College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Spine Center PAGroup PAC ID 6901890300, 38 clinicians

Practice addresses (Care Compare)

1699 S 14TH St
Suite 16
Fernandina Beach, FL 32034-1965
Phone (904) 223-3321

Hospital & facility affiliations

  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
70.19
Promoting interoperability
98
Improvement activities
40
Cost
68.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Spine Center PA Interventional Pain Medicine CurrentSince Oct 1, 2020 Accepting new patients
Professional Anesthesia Service,Inc. Anesthesiology CurrentSince Feb 28, 2020 Accepting new patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Feb 9, 2023 Accepting new patients
Jacksonville Spine Center PA Interventional Pain Medicine CurrentSince Oct 1, 2020 Accepting new patients
Georgia Spine & Pain Centers Interventional Pain Medicine Past Accepting new patients

Locations

1699 S 14th St
Ste 16
Fernandina Beach, FL 32034
Phone (904) 491-7700

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

5191 First Coast Tech Pkwy
Jacksonville, FL 32224
Phone (904) 427-7399

5191 First Coast Tech Pkwy
Fl 3
Jacksonville, FL 32224
Phone (904) 222-3332

15255 Max Leggett Pkwy
Ste 5500
Jacksonville, FL 32218

10475 Centurion Pkwy N
Ste 201
Jacksonville, FL 32256
Phone 90422333213118

1350 13th Ave S
Jax Bch, FL 32250
Phone (904) 247-2900

1351 13th Ave S
Ste 120
Jax Bch, FL 32250
Phone (904) 257-4020

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

205 Zeagler Dr
Ste 401
Palatka, FL 32177
Phone (386) 328-0202

1100 Plantation Island Dr S
Ste 220
Saint Augustine, FL 32080
Phone (904) 436-6420

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

110 Roane St
Charleston, WV 25302
Phone (304) 344-0096

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: nicholas.bremer@jspc.eclinicaldirectplus.com

Organizations & group practices 5

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 1

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1083778468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY",
            "address_2": "3RD FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 S 14TH ST STE 16",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341965",
            "telephone_number": "904-223-3321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15255 Max Leggett Pkwy Ste 5500",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187273",
            "country_code": "US",
            "telephone_number": "904-223-3321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5191 First Coast Tech Pkwy",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322240609",
            "country_code": "US",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREMER",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME126043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108108900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.