Individual provider Active NPI

Hannah Dickinson

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1154017606
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117949 Issued in FL
Practice address
14546 Old Saint Augustine Rd Ste 407
Jacksonville, FL 32258-5473
Phone
(904) 262-3372
NPI assigned
Apr 17, 2023
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9117949 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

14546 Old Saint Augustine Rd Ste 407
Jacksonville, FL 32258-5473

Mailing address

14546 Old Saint Augustine Rd Ste 407
Jacksonville, FL 32258-5473
Phone (904) 262-3372

Other practice location 1

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088
Phone (904) 245-8910

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
I20231030001973 FL Practitioner - Physician Assistant 7618323528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1747 Baptist Clay Dr
Suite 240
Fleming Island, FL 32003-8505
Phone (904) 214-8161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Oct 20, 2023 Accepting new patients
North Florida Surgeons, PA CurrentSince Oct 20, 2023 Accepting new patients

Locations

1747 Baptist Clay Dr
Ste 240
Fleming Island, FL 32003
Phone (904) 214-8161

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

14546 Old St Augustine Rd
Ste 407
Jacksonville, FL 32258
Phone (904) 262-3372

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: hannah.dickinson.1@9109.direct.athenahealth.com

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 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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1154017606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD STE 407",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585473",
            "telephone_number": "904-262-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD STE 407",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585473",
            "telephone_number": "904-262-3372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6675 Corporate Center Pkwy Ste 115",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168088",
            "country_code": "US",
            "telephone_number": "904-245-8910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117949",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.