Individual provider Active NPI

Julian Clouse, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1184230583
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9803 Creekfront Rd Apt 307
Jacksonville, FL 32256-8449
Phone
(815) 735-0506
NPI assigned
Sep 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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 Primary

Addresses

Primary practice location

9803 Creekfront Rd Apt 307
Jacksonville, FL 32256-8449

Mailing address

9803 Creekfront Rd Apt 307
Jacksonville, FL 32256-8449
Phone (815) 735-0506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210211002569 OH Practitioner - Physician Assistant 1052726643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Urology LLCGroup PAC ID 6608977459, 9 clinicians

Practice addresses (Care Compare)

1164 E Home Rd
Suite J
Springfield, OH 45503-2726
Phone (937) 342-9260

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 342-9260

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: julian.clouse.p2@direct.springfieldurology.nextgenshare.com

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 and National Provider Directory roles.

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1184230583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9803 CREEKFRONT RD APT 307",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568449",
            "telephone_number": "815-735-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9803 CREEKFRONT RD APT 307",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568449",
            "telephone_number": "815-735-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUSE",
        "first_name": "JULIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.