Individual provider Active NPI

Paul A Walker, M.D.

  • Otolaryngology Physician
  • Fleming Island, FL
National Provider Identifier
1285627497
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME123209 Issued in FL
Practice address
1747 Baptist Clay Dr
Suite 230
Fleming Island, FL 32003-8502
Phone
(904) 592-1068
Fax
(904) 541-4728
NPI assigned
Aug 24, 2005
Last updated
Oct 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 043504 GA
Otolaryngology Physician 207Y00000X ME123209 FL Primary

Addresses

Primary practice location

1747 Baptist Clay Dr
Suite 230
Fleming Island, FL 32003-8502

Mailing address

PO Box 41113
Jacksonville, FL 32203-1113
Phone (904) 202-5111

Other identifiers 2

IdentifierTypeStateIssuer
00744983AMedicaidGA
014718200MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150805008803 FL Practitioner - Otolaryngology 1355447293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Rush Medical College of Rush University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1747 Baptist Clay Dr
Suite 230
Fleming Island, FL 32003-8505
Phone (904) 592-1068

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043504GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Aug 1, 2023 Accepting new patients
North Florida Surgeons, PA CurrentSince Aug 1, 2023 Accepting new patients

Locations

1747 Baptist Clay Dr
Ste 230
Fleming Island, FL 32003
Phone (904) 592-1068

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

14546 Old St Augustine Rd
Ste 401
Jacksonville, FL 32258
Phone (904) 268-5366

7740 Point Meadows Dr
Ste 7
Jacksonville, FL 32256
Phone (904) 202-6400

Interoperability endpoints

  • Direct secure messaging: paul.walker.1@9109.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1285627497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41113",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322031113",
            "telephone_number": "904-202-5111",
            "fax_number": "904-391-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 BAPTIST CLAY DR",
            "address_2": "SUITE 230",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038502",
            "telephone_number": "904-592-1068",
            "fax_number": "904-541-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "043504",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME123209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00744983A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014718200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.