Individual provider Active NPI

Justin Hebert

  • Interventional Pain Medicine Physician
  • Pensacola, FL
National Provider Identifier
1356704308
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME148459 Issued in FL
Practice address
4624 N Davis Hwy
Pensacola, FL 32503-2337
Phone
(850) 494-0000
Fax
(850) 494-0001
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X ME148459 FL Primary

Addresses

Primary practice location

4624 N Davis Hwy
Pensacola, FL 32503-2337

Mailing address

4624 N Davis Hwy
Pensacola, FL 32503-2337
Phone (850) 494-0000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@pcofwfla.e-mdsdirect.com

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
I20210524001619 FL Practitioner - Interventional Pain Management 1456646074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain Management
Education
University of Mississippi School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Consultants of West Florida P aGroup PAC ID 3274522206, 6 clinicians

Practice addresses (Care Compare)

4624 N Davis Hwy
Pensacola, FL 32503-2337
Phone (850) 494-0000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.81 of 100Reported as group
Quality
73.34
Improvement activities
40
Cost
78.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME148459FLMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Consultants of West Florida P a Interventional Pain Medicine CurrentSince Jul 12, 2021 Accepting new patients
Pain Consultants of West Florida CurrentSince Apr 11, 2021 Accepting new patients

Locations

511 Hewitt St
Pensacola, FL 32503
Phone (850) 912-6505

4624 N Davis Hwy
Pensacola, FL 32503
Phone 85049400002014

Interoperability endpoints

  • Direct secure messaging: admin@pcofwfla.e-mdsdirect.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 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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1356704308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-494-0000",
            "fax_number": "850-494-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-494-0000",
            "fax_number": "850-494-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME148459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@pcofwfla.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "4624 N Davis Hwy",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325032337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.