NPIMap

Individual provider Active NPI

Jesse Tyler Lyons, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1437716529
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME163619 Issued in FL
Practice address
4530 Saint Johns Ave Ste 13
Jacksonville, FL 32210-1852
Phone
(904) 384-5222
Fax
(904) 390-7461
NPI assigned
May 23, 2019
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X ME163619 FL
Family Medicine Physician 207Q00000X ME163619 FL Primary

Addresses

Primary practice location

4530 Saint Johns Ave Ste 13
Jacksonville, FL 32210-1852

Mailing address

PO Box 40767
Jacksonville, FL 32203-0767
Phone (904) 376-3707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830000765 FL Practitioner - Family Practice 9335571389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

4530 Saint Johns Ave
Suite 13
Jacksonville, FL 32210-1852
Phone (904) 384-5222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME163619FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc. Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients

Locations

1660 Prudential Dr
Ste 400
Jacksonville, FL 32207
Phone (904) 396-0000

4530 Saint Johns Ave
Ste 13
Jacksonville, FL 32210
Phone (904) 384-5222

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

Interoperability endpoints

  • Direct secure messaging: jlyons147775@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 3

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 11

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": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1437716529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40767",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322030767",
            "telephone_number": "904-376-3707",
            "fax_number": "904-391-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 SAINT JOHNS AVE STE 13",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101852",
            "telephone_number": "904-384-5222",
            "fax_number": "904-390-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "JESSE",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME163619",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME163619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.