Jesse E Phillips, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

01040385A Issued in IN

Practice address

4632 S 25TH St
Fort Pierce, FL 34981-5057

Phone

(772) 464-9595

Fax

(772) 460-2624

NPI assigned

Jul 27, 2005

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 2

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

OtolaryngologyAlso: Sleep Medicine

Education

Indiana University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246
• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jphillips@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.

• ENT and Allergy Associates of Florida, LLC

  • Otolaryngology Physician
  • Boca Raton, FL
  • NPI 1164473120
  Medicare reassignment Care Compare group
• Anesthesia Care of Bloomington PC

  • Anesthesiology Physician
  • Bloomington, IN
  • NPI 1093990541
  NPD (past)
• Monroe Physicians Group

  • General Acute Care Hospital
  • Bloomington, IN
  • NPI 1588863534
  NPD (past)

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

• Lawnwood Medical Center Inc

  • General Acute Care Hospital
  • Fort Pierce, FL
  • NPI 1568409647
  Care Compare affiliation
• Martin Memorial Medical Center Inc

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  Care Compare affiliation

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1457351983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-464-9595",
            "fax_number": "772-460-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-464-9595",
            "fax_number": "772-460-2624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1731 SW Gatlin Blvd",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349532757",
            "country_code": "US",
            "telephone_number": "772-344-0022",
            "fax_number": "772-344-0032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JESSE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01040385A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "00000209641",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100462620A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pharmacist Consultant Services, LLC
• Ida Marlene Pharr, L.C.S.W.
• Tatyana Philipp
• Corliss Y Phillips, LPN
• Helene P Phillips
• Rebecca Phillips, MA
• Tangela Phillips
• Phoenix Anesthesia PLLC
• Phyllis McColister-Cunningham PA
• Phyllis McColister-Cunningham PA

• Otolaryngology Physician in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.