Individual provider Active NPI

Andrew Brian Kirkland

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1174038970
Registry record updated Dec 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111019 Issued in FL
Practice address
4201 Belfort Rd
Jacksonville, FL 32216-1431
Phone
(904) 296-3784
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111019 FL Primary

Addresses

Primary practice location

4201 Belfort Rd
Jacksonville, FL 32216-1431

Mailing address

4201 Belfort Rd
Jacksonville, FL 32216-1431
Phone (904) 296-3784

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
I20180410003148 FL Practitioner - Physician Assistant 1951664630 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111019FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jun 21, 2023 Accepting new patients
Cep America LLC CurrentSince Jun 21, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703462400000",
    "number": "1174038970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161431",
            "telephone_number": "904-296-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161431",
            "telephone_number": "904-296-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "ANDREW",
        "middle_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2023-12-25",
        "certification_date": "2023-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.