Individual provider Active NPI

Jason A Pietryga, MD

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1336309053
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME172183 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Jun 16, 2008
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X LP01317 RI
Diagnostic Radiology Physician 2085R0202X 35120993 OH
Diagnostic Radiology Physician 2085R0202X MD33400 AL
Diagnostic Radiology Physician 2085R0202X MD15680 RI
Diagnostic Radiology Physician 2085R0202X 2012-00525 NC
Diagnostic Radiology Physician 2085R0202X ME172183 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

PO Box 55310
Birmingham, AL 35255-5310

Other practice location 1

20 Catamore Blvd
East Providence, RI 02914-1204
Phone (401) 432-2500 ext. 1302

Other practice location 2

619 19th St S
Birmingham, AL 35249
Phone (205) 934-4011

Other practice location 3

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jpietryga789890@direct.UNC.nchie.net Direct
Direct Messaging Address jpietryga2528980@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AL, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20120614000017 NC Practitioner - Diagnostic RadiologyPractitioner - Radiation Oncology 8729242243 Reassigns benefits to 1 organization
I20140811002189 AL Practitioner - Diagnostic Radiology 8729242243 Reassigns benefits to 1 organization
I20250522003291 FL Practitioner - Diagnostic Radiology 8729242243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD33400ALMDDiagnostic Radiology Physician
35120993OHMDDiagnostic Radiology Physician
LP01317RIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince May 19, 2025 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Aug 1, 2014 Accepting new patients
Mayo Clinic Jacksonville CurrentSince May 19, 2025 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Jan 31, 2022 Accepting new patients
University of North Carolina at Chapel Hill Family Medicine CurrentSince Jan 31, 2022 Accepting new patients
Mayo Clinic Jacksonville Current Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology PastSince Jun 26, 2022 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

Interoperability endpoints

  • Direct secure messaging: jpietryga2528980@ehrdirect.mayoclinicmsg.org
  • Direct secure messaging: jpietryga789890@direct.unc.nchie.net

Organizations & group practices 7

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 2

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1336309053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Catamore Blvd",
            "address_purpose": "LOCATION",
            "city": "East Providence",
            "state": "RI",
            "postal_code": "029141204",
            "country_code": "US",
            "telephone_number": "401-432-2500 x1302",
            "fax_number": "401-453-8220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "35249",
            "country_code": "US",
            "telephone_number": "205-934-4011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "984-974-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIETRYGA",
        "first_name": "JASON",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "LP01317",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35120993",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "MD33400",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD15680",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2012-00525",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME172183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpietryga789890@direct.UNC.nchie.net",
            "affiliation": "N",
            "endpointDescription": "CDA/CCD/TXT",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpietryga2528980@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.