Individual provider Active NPI

Scott Richard Jason, DPM

  • Foot Surgery Podiatrist
  • Palatka, FL
National Provider Identifier
1407845530
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
PO289896 Issued in FL
Practice address
3600 Crill Ave
Palatka, FL 32177-8112
Phone
(386) 325-7541
Fax
(386) 325-7204
NPI assigned
Oct 20, 2005
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X PO289896 FL Primary

Addresses

Primary practice location

3600 Crill Ave
Palatka, FL 32177-8112

Mailing address

3600 Crill Ave
Palatka, FL 32177-8112
Phone (386) 325-7541

Other identifiers 1

IdentifierTypeStateIssuer
65727OtherFLBLUE CROSS BLUE SHIELD ID

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000217 FL Practitioner - Podiatry 3870499908 Reassigns benefits to 1 organization
Practice locations: Palatka, FL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3600 Crill Ave
Palatka, FL 32177-8112
Phone (386) 325-7541

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue17
Removal of skin lesions37
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO289896FLMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Foot Clinic PLLC CurrentSince Feb 15, 2021 Accepting new patients

Locations

3600 Crill Ave
Palatka, FL 32177
Phone (386) 325-7541

Interoperability endpoints

  • Direct secure messaging: drscottjason@drjdsjd-fl.direct.office.nextgen.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1407845530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321778112",
            "telephone_number": "386-325-7541",
            "fax_number": "386-325-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321778112",
            "telephone_number": "386-325-7541",
            "fax_number": "386-325-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASON",
        "first_name": "SCOTT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO289896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "65727",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

Verify at the official NPI Registry.