Jason W Thackeray, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME77615 Issued in FL

Practice address

1034 Mar Walt Dr
Suite 100
Fort Walton Beach, FL 32547-6645

Phone

(850) 863-2153

Fax

(850) 863-2885

NPI assigned

Jun 13, 2005

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

Other identifiers 1

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

Specialty

Orthopedic Surgery

Education

University of Florida College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.79 of 100Reported as group

Quality

64.42

Promoting interoperability

100

Improvement activities

40

Cost

74.88

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.thackeray.1@9109.direct.athenahealth.com
• Direct secure messaging: jthackeray@direct.orthoassociates.net

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.

• Orthopaedic Associates, PA

  • Orthopaedic Surgery Physician
  • Fort Walton Beach, FL
  • NPI 1467589010
  Medicare reassignment NPD
• Jason W Thackeray MD PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fort Walton Beach, FL
  • NPI 1568504173
  NPD Authorized official
• Orthopaedic Associates PA

  • Orthopaedic Surgery Physician
  • Panama City, FL
  • NPI 1255001350
  NPD
• Surgical Specialists ASC, LLC

  • Ambulatory Surgical Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1780871319
  NPD
• Orthopaedic Associates PA

  • Orthopaedic Surgery Physician
  • Destin, FL
  • NPI 1124155783
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1235133646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "address_2": "SUITE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-2153",
            "fax_number": "850-863-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR",
            "address_2": "SUITE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-2153",
            "fax_number": "850-863-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKERAY",
        "first_name": "JASON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME77615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265809700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riley Mae Tegtmeier, RBT
• Mark J Tenholder, MD PA
• Amie Terbrak, MOT, OTR/L
• Susan Wren Terry
• Barry Thomas Teusch
• Lam Thai
• The Spine Institute at Orthopaedic Associates PL
• The Village ABA, LLC
• Theodore I Macey MD PA
• Therapy Tree to Life LLC

• Orthopaedic Surgery Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.