Individual provider Active NPI

Jeremy Ron Alquizar

  • Primary Care Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1104777598
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11043624 Issued in FL
Practice address
1851 Old Moultrie Rd
St Augustine, FL 32084-4168
Phone
(904) 824-8088
NPI assigned
Feb 3, 2026
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11043624 FL Primary

Addresses

Primary practice location

1851 Old Moultrie Rd
St Augustine, FL 32084-4168

Mailing address

7154 Ambrosius Way
Jacksonville, FL 32258-6541
Phone (904) 887-7459

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260303000758 FL Practitioner - Nurse Practitioner 3577045343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
James F Connor PAGroup PAC ID 3870563315, 4 clinicians

Practice addresses (Care Compare)

1851 Old Moultrie Rd a
Saint Augustine, FL 32084-4167
Phone (904) 824-8088

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11043624FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
James F Connor PA CurrentSince Feb 23, 2026 Accepting new patients
Paul D Jayachandra M D P a PastSince Feb 23, 2026 Accepting new patients

Locations

1851 Old Moultrie Rd
Ste A
St Augustine, FL 32084
Phone (904) 824-7476

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHJBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHJBA/Endpoint/IBHJBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1770076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1104777598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7154 AMBROSIUS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322586541",
            "telephone_number": "904-887-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 OLD MOULTRIE RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844168",
            "telephone_number": "904-824-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALQUIZAR",
        "first_name": "JEREMY",
        "middle_name": "RON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11043624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.