Individual provider Active NPI

Jacob Logan Huffman, DPM

  • Podiatrist
  • Casselberry, FL
National Provider Identifier
1104383512
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO4242 Issued in FL
Practice address
178 Wilshire Blvd
Casselberry, FL 32707-5352
Phone
(407) 671-8010
Fax
(407) 915-9615
NPI assigned
Feb 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X PO4242 FL
Sports Medicine Podiatrist 213ES0000X PO4242 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO4242 FL
Foot Surgery Podiatrist 213ES0131X PO4242 FL
Podiatrist 213E00000X PO4242 FL Primary

Addresses

Primary practice location

178 Wilshire Blvd
Casselberry, FL 32707-5352

Mailing address

15815 Shaddock Dr Ste 130
Winter Garden, FL 34787-5773
Phone (813) 400-1140

Other practice location 1

1000 Executive Dr Ste 9
Oviedo, FL 32765-8140
Phone (407) 588-1598

Other identifiers 3

IdentifierTypeStateIssuer
109820200MedicaidFL
15074479OtherCAQH ID
QWOYUOtherFLBCBS

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210308001848 FL Practitioner - Podiatry 7012323587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Podiatry Group Inc.Group PAC ID 0042252140, 42 clinicians

Practice addresses (Care Compare)

178 Wilshire Blvd
Casselberry, FL 32707-5352
Phone (407) 671-8010

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue48
Removal of skin lesions1-10
Removal of nail tissue716
Removal or shaving of skin growth459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO4242FLMDSports Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
All Podiatry Group Inc Podiatrist CurrentSince Apr 1, 2021 Accepting new patients
Anne McNamara DPM PL Podiatrist PastSince Apr 1, 2021 Accepting new patients

Locations

540 Medical Oaks Ave
Ste 101
Brandon, FL 33511
Phone (813) 681-3558

178 Wilshire Blvd
Casselberry, FL 32707
Phone (407) 331-4115

1000 Executive Dr
Ste 9
Oviedo, FL 32765
Phone (407) 588-1598

2511 W Mlk Blvd
Tampa, FL 33607
Phone (813) 400-1140

15815 Shaddock Dr
Ste 130
Winter Garden, FL 34787
Phone (407) 605-2321

Organizations & group practices 2

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 2

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": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1104383512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15815 SHADDOCK DR STE 130",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875773",
            "telephone_number": "813-400-1140",
            "fax_number": "813-701-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 WILSHIRE BLVD",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075352",
            "telephone_number": "407-671-8010",
            "fax_number": "407-915-9615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Executive Dr Ste 9",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327658140",
            "country_code": "US",
            "telephone_number": "407-588-1598",
            "fax_number": "321-296-7207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "JACOB",
        "middle_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-22",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO4242",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "FL",
            "license": "PO4242",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4242",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO4242",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO4242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109820200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "15074479",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "QWOYU",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

Verify at the official NPI Registry.