Jesse Judelle, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME23983 Issued in FL

Practice address

1300 Medical Dr
Tallahassee, FL 32308-4646

Phone

(850) 216-0100

NPI assigned

Jun 22, 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 8

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment NPD
• Tallahassee Memorial Healthcare Inc

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102

  Internal Medicine

  NPD
• Tallahassee Memorial Healthcare Inc

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1770647620
  NPD
• Southern Medical Group, PA

  • Cardiovascular Disease Physician
  • Tallahassee, FL
  • NPI 1417948159
  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1336145663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084646",
            "telephone_number": "850-216-0100",
            "fax_number": "850-216-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084646",
            "telephone_number": "850-216-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDELLE",
        "first_name": "JESSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME23983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL HEALTH CARE",
            "identifier": "01092",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051174900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN NETWORK",
            "identifier": "00000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HC",
            "identifier": "00000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF FLORIDA",
            "identifier": "00000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHCARE NETWORK",
            "identifier": "00000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVOUTIONS HC",
            "identifier": "0000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH ST/CAPP CARE",
            "identifier": "00000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Journey to Resilience Counseling Services, LLC
• Twila Jowers, LCSW
• Joy of Therapy PLLC
• Hilary A Joyner, PA -C
• JTJ Medical Supply, Inc.
• Steven C Judge, PA-C
• Tyressa Judge, PT
• Judi Fergus
• Julian R Alford Jr OD P a
• Julie B Jaekel LCSW

• Internal Medicine Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.