Individual provider Active NPI

Michael Emil Copty, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1174102792
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME174844 Issued in FL
Practice address
9504 Crosshill Blvd Ste 108
Jacksonville, FL 32222-5851
Phone
(904) 308-7792
NPI assigned
Apr 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME174844 FL Primary

Addresses

Primary practice location

9504 Crosshill Blvd Ste 108
Jacksonville, FL 32222-5851

Mailing address

9504 Crosshill Blvd Ste 108
Jacksonville, FL 32222-5851
Phone (904) 308-7792

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
I20250820000299 FL Practitioner - Internal Medicine 5799149514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1545 Branan Field Rd
Suite 1
Middleburg, FL 32068-8429
Phone (904) 450-8575

1801 Barrs St
Suite 120
Jacksonville, FL 32204-4738
Phone (904) 308-2006

9504 Crosshill Blvd
Suite 108
Jacksonville, FL 32222-5851
Phone (904) 308-7792

Hospital & facility affiliations

  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME174844FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

9504 Crosshill Blvd
Ste 108
Jacksonville, FL 32222
Phone (904) 308-7792

1545 Branan Field Rd
Ste 1
Middleburg, FL 32068
Phone (904) 450-8575

Interoperability endpoints

  • Direct secure messaging: michael.copty.1@8967.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1174102792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9504 CROSSHILL BLVD STE 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225851",
            "telephone_number": "904-308-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9504 CROSSHILL BLVD STE 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225851",
            "telephone_number": "904-308-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPTY",
        "first_name": "MICHAEL",
        "middle_name": "EMIL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME174844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.