Individual provider Active NPI

Paul D. Zawatsky, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1164431037
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME63004 Issued in FL
Practice address
11481 Old Saint Augustine Rd Ste 103
Jacksonville, FL 32258-1474
Phone
(904) 260-8424
Fax
(904) 341-4777
NPI assigned
Aug 7, 2006
Last updated
May 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME63004 FL Primary
Sports Medicine (Family Medicine) Physician 207QS0010X ME63004 FL

Addresses

Primary practice location

11481 Old Saint Augustine Rd Ste 103
Jacksonville, FL 32258-1474

Mailing address

11481 Old Saint Augustine Rd Ste 103
Jacksonville, FL 32258-1474
Phone (904) 260-8424

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120209000456 FL Practitioner - Family PracticePractitioner - Sports Medicine 6507023181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians

Practice addresses (Care Compare)

10609 Old Saint Augustine Rd
Suite 4
Jacksonville, FL 32257-1019
Phone 90426084242

1390 Boone Ave Ext
Suite A23
Kingsland, GA 31548-6515
Phone (419) 221-3717

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME63004FLMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paul D. Zawatsky, MD, PA Sports Medicine CurrentSince Sep 20, 2002 Accepting new patients

Locations

10609 Old St Augustine Rd
Ste 4
Jacksonville, FL 32257
Phone (904) 260-8424

11481 Old Saint Augustine Rd
Ste 103
Jacksonville, FL 32258
Phone (904) 260-8424

Organizations & group practices 1

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 3

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1164431037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11481 OLD SAINT AUGUSTINE RD STE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581474",
            "telephone_number": "904-260-8424",
            "fax_number": "904-341-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11481 OLD SAINT AUGUSTINE RD STE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581474",
            "telephone_number": "904-260-8424",
            "fax_number": "904-341-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAWATSKY",
        "first_name": "PAUL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME63004",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME63004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.