Cameron David Adkisson, MD
Individual provider Active NPI Surgery Physician · Jacksonville, FL
NPI 1205080652 · NPPES record last updated Aug 12, 2015
Key facts
- NPI
- 1205080652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- ME105034 (FL)
- Practice address
- 14540 Old Saint Augustine Rd
2571
Jacksonville, FL 32258-7418 - Phone
- (904) 886-2251
- Fax
- (904) 886-7151
- NPI assigned
- Nov 12, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Texas Medical Branch at Galveston, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Florida Surgeons PA
Practice addresses (Care Compare)
14540 Old Saint Augustine Rd
Suite 2571
Jacksonville, FL 32258-7420
Phone (904) 886-2251
Hospital & facility affiliations
- Baptist Health Medical Center - Jacksonville
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.78 of 100
- Quality
- 68.7
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair (minimally invasive) | 52 |
| Mastectomy | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150630001725 | FL | Practitioner - General Surgery | 0244476810 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME105034 | FL | MD | Surgery Physician |
| MD447547 | WI | MD | Surgery Physician |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Florida Surgeons, PA | Surgery | Current |
Accepting new patients |
| North Florida Surgeons, PA | Current |
Accepting new patients |
Locations
14540 Old St Augustine Rd
Ste 2571
Jacksonville, FL 32258
Phone (904) 886-2251
836 Prudential Dr
Ste 1001
Jacksonville, FL 32207
Phone (904) 398-0004
11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937
11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223
Networks
- Freedom Health HMO Network
Interoperability endpoints
- cameron.adkisson.1@9109.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD447547 | WI | |
| Surgery Physician | 208600000X | 57500 | MN | |
| Surgery Physician | 208600000X | ME105034 | FL | Yes |
Addresses
Primary practice location
14540 Old Saint Augustine Rd
2571
Jacksonville, FL 32258-7418
Mailing address
11945 San Jose Blvd
#300
Jacksonville, FL 32223-1613
Phone (904) 396-1725
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I506J | Other | FL | BCBS-FL |
Other providers in Jacksonville, FL
- Tele-Marlys Adjevi-Neglokpe
- Daniel Zachary Adkins
- Marilee Kay Adkins
- Rachel Adkins
- Timothy Wayne Adkins
- Kendall Beth Adkisson
- Adler Podiatry and Wound Care LLC
- Adler Podiatry Clinic PLLC
- Benjamin Adler
- Grit Armstrong Adler
All providers in Jacksonville, FL · Surgery Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.