Manuel Gervasio Ruiz Dicks Jr.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3226112 Issued in FL

Practice address

6428 Beach Blvd
Jacksonville, FL 32216-2813

Phone

(904) 475-2039

Fax

(904) 330-0668

NPI assigned

Dec 15, 2017

Last updated

Sep 29, 2023By the provider in NPPES

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

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

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Specialists of Northeast Florida PLLCGroup PAC ID 4587848163, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medical Specialists of Northeast Florida PLLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1285938936
  Medicare reassignment Care Compare group NPD
• University of Florida Jacksonville Physicians Inc

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1326208695
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1487814752
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians, Inc.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1235398983
  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• S S Marathe MD PA

  dba Medical Specialists PA

  • Nephrology Physician
  • St Augustine, FL
  • NPI 1275584492
  NPD (past)
• University of Florida Jacksonville Physicians, Inc.

  • Family Medicine Physician
  • Yulee, FL
  • NPI 1518126168
  NPD (past)

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1184130916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6428 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162813",
            "telephone_number": "904-475-2039",
            "fax_number": "904-330-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6428 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162813",
            "telephone_number": "904-475-2039",
            "fax_number": "904-330-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKS",
        "first_name": "MANUEL GERVASIO",
        "middle_name": "RUIZ",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-15",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3226112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin K Dickerson
• Alexis Frances Dickey, BS,
• Benjamin Olson Dickey, CAA
• Erika Lyn Dickinson, MD
• Hannah Dickinson
• Deandra Dominique Dickson
• Dennis Dickson, MD
• Misty Jo Dickson, M.ED
• Rebecca Ann Didi, A.R.N.P.
• Mark Edward Diebel

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.