Jacob Urda, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS14821 Issued in FL

Practice address

130 E Redstone Ave
Crestview, FL 32539-5348

Phone

(850) 398-8725

Fax

(850) 398-8727

NPI assigned

Apr 16, 2015

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 1

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

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White-Wilson Medical Center PAGroup PAC ID 4082510607, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Shalimar, FL, CCN 107240
• Amedisys Home Health Home health agency, Pensacola, FL, CCN 108309
• North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122
• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
• HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.urda.1@21123.direct.athenahealth.com
• Direct secure messaging: jurda141@yourcarecommunity.org

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.

• White-Wilson Medical Center PA

  • Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1467437277
  Medicare reassignment Care Compare group NPD
• WW Medical Center, PA

  • Clinic/Center
  • Fort Walton Beach, FL
  • NPI 1225981707
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centerwell Health Services (Certified), Inc.

  • Home Health Agency
  • Shalimar, FL
  • NPI 1518991215
  Care Compare affiliation Name & address match
• Amedisys Florida, LLC

  • Home Health Agency
  • Pensacola, FL
  • NPI 1679685085
  Care Compare affiliation
• Crestview Hospital Company, LLC

  • General Acute Care Hospital
  • Crestview, FL
  • NPI 1104897859
  Care Compare affiliation
• Fort Walton Beach Medical Center, Inc.

  • General Acute Care Hospital
  • Ft Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation
• Okaloosa Hospital Inc

  • General Acute Care Hospital
  • Niceville, FL
  • NPI 1891732988
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1427445477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8150",
            "fax_number": "850-863-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E REDSTONE AVE",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395348",
            "telephone_number": "850-398-8725",
            "fax_number": "850-398-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URDA",
        "first_name": "JACOB",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-16",
        "last_updated": "2021-09-10",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103696500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana Turner
• Cynthia Marie Turner, RBT
• Unplugged Minds, LLC
• Ur Dental, PLLC
• Leilani Urap Cook
• Jared Ure, DMD
• Jessica Carolina Urena
• Tamika D Ussery-Freeman, MD
• Alexandra Van Dyke
• Jennifer Lanier Van Vrancken, D.P.T.

• Family Medicine Physician in Crestview, FL
• Providers in Crestview, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.