NPIMap

Individual provider Active NPI

Jonathan D Screnock, M.D.

  • Family Medicine Physician
  • Palm Coast, FL
National Provider Identifier
1285677294
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME120275 Issued in FL
Practice address
120 Cypress Edge Dr Ste 204
Palm Coast, FL 32164-8454
Phone
(386) 586-4428
Fax
(386) 586-4432
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME120275 FL Primary
Family Medicine Physician 207Q00000X 40243 WI

Addresses

Primary practice location

120 Cypress Edge Dr Ste 204
Palm Coast, FL 32164-8454

Mailing address

120 Cypress Edge Dr Ste 204
Palm Coast, FL 32164-8454
Phone (386) 586-4428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140917002269 FL Practitioner - Family Practice 9537155239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

120 Cypress Edge Dr
Suite 202
Palm Coast, FL 32164-8454
Phone (386) 586-4280

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Brooks Rehabilitation Home Health Home health agency, Daytona Beach, FL, CCN 107628
  • Adventhealth Home Health Home health agency, Ormond Beach, FL, CCN 107408
  • Bravery Home Healthcare Home health agency, St Augustine, FL, CCN 687344
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
  • Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40243WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

120 Cypress Edge Dr
Ste 202
Palm Coast, FL 32164
Phone (386) 586-4462

120 Cypress Edge Dr
Ste 102
Palm Coast, FL 32164
Phone (386) 586-4280

120 Cypress Edge Dr
Ste 204
Palm Coast, FL 32164
Phone (386) 586-4428

120 Cypress Edge Dr
Ste 210
Palm Coast, FL 32164
Phone (386) 445-4750

Interoperability endpoints

  • Direct secure messaging: jscrenock73471@adventhealth.direct-ci.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 9

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1285677294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CYPRESS EDGE DR STE 204",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648454",
            "telephone_number": "386-586-4428",
            "fax_number": "386-586-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CYPRESS EDGE DR STE 204",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648454",
            "telephone_number": "386-586-4428",
            "fax_number": "386-586-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRENOCK",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME120275",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "40243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.