John Michael Tierney, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102882 Issued in FL

Practice address

14540 Old Saint Augustine Rd
Suite 2201
Jacksonville, FL 32258-7418

Phone

(904) 880-1260

Fax

(904) 880-1210

NPI assigned

Jun 14, 2005

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

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Orthopaedic Institute IncGroup PAC ID 5193625499, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Merit-based Incentive Payment System (MIPS)

Final score

87.01 of 100Reported as group

Improvement activities

40

Cost

74.03

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jtierney@joi.medalliesdirect.net

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.

• Jacksonville Orthopaedic Institute Inc

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
  • NPI 1346298023
  Medicare reassignment Care Compare group
• Jacksonville Orthopaedic Institute Inc

  • Orthopaedic Surgery Physician
  • Jacksonville Beach, FL
  • NPI 1851496723
  NPD (past)
• John H Peloza MD PA

  • Orthopaedic Surgery of the Spine Physician
  • Dallas, TX
  • NPI 1053364547
  NPD (past)
• Peloza Surgical Services, PLLC

  • Orthopaedic Surgery of the Spine Physician
  • Dallas, TX
  • NPI 1265893085

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1124023445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078566",
            "telephone_number": "904-346-3465",
            "fax_number": "904-880-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 2201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322587418",
            "telephone_number": "904-880-1260",
            "fax_number": "904-880-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292014000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylee Lynn Tibbetts, PTA
• Morgan Tibbo, DO
• Kendra J Tice, RN, MSN,DNP
• Mary Tice, PA
• Tidajay Care Services Inc
• Sara Beth Tierney, LCSW
• Vicki D Tierney, OTR, MHS
• Tiffany Baltiero LMT LLC
• Tiffany'S Homemaker and Companion
• Robin Shepherd Tighe, APRN

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.