Individual provider Active NPI

Terri Aminah Jackson-Niiquaye, M.D.

  • Surgical Critical Care Physician
  • Panama City, FL
National Provider Identifier
1265589956
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
ME171553 Issued in FL
Practice address
615 N Bonita Ave
Panama City, FL 32401-3623
Phone
(850) 769-1511
Fax
(850) 416-6159
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X ME171553 FL Primary

Addresses

Primary practice location

615 N Bonita Ave
Panama City, FL 32401-3623

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, AL, FL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20040322001745 DC Practitioner - General Surgery 6608767439 Reassigns benefits to 2 organizations
I20050304000300 MD Practitioner - General Surgery 6608767439 Reassigns benefits to 2 organizations
I20231002000467 AL Practitioner - General Surgery 6608767439 Reassigns benefits to 1 organization
I20250114003978 FL Practitioner - Critical Care (Intensivists) 6608767439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Miami, LM Miller School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wiregrass Clinic LLCGroup PAC ID 2860662491, 69 clinicians
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

4370 W Main St
Dothan, AL 36305-1056
Phone (334) 793-4613

5151 N 9TH Ave
Suite 200
Pensacola, FL 32504-8721
Phone (850) 416-4188

Hospital & facility affiliations

  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
  • Flowers Hospital Hospital, Dothan, AL, CCN 010055
  • Ascension Sacred Heart Gulf Hospital, Port Saint Joe, FL, CCN 100313
  • Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

Merit-based Incentive Payment System (MIPS)

Final score
96.64 of 100Reported as group
Quality
88.96
Promoting interoperability
100
Improvement activities
40
Cost
73.82

Merit-based Incentive Payment System (MIPS)

Final score
87.97 of 100Reported as apm
Quality
75.95
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Dec 18, 2024 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Apr 3, 2017 Accepting new patients
Anacostia Medical Associates CurrentSince Jun 1, 2024 Accepting new patients
Sacred Heart Health System Inc CurrentSince Dec 18, 2024 Accepting new patients
Dimensions Healthcare Associates, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Triad of Alabama LLC Past Accepting new patients
Center for Hemorrhoid Relief, LLC Past Accepting new patients
Hemorrhoid Relief Center of Virginia, Inc. Past Accepting new patients
Center for Vein Restoration MD LLC Past Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

5151 N 9th Ave
Ste 200
Pensacola, FL 32504
Phone (850) 416-4188

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

2900 Mercy Ln
Cheverly, MD 20785
Phone (301) 618-2010

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

Interoperability endpoints

  • Direct secure messaging: tjacksonniiquaye801596@direct.umm.edu

Organizations & group practices 11

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1265589956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BONITA AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013623",
            "telephone_number": "850-769-1511",
            "fax_number": "850-416-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-NIIQUAYE",
        "first_name": "TERRI",
        "middle_name": "AMINAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME171553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.