Individual provider Active NPI

John P Donovan, MD

  • Ophthalmology Physician
  • Orange Park, FL
National Provider Identifier
1508821844
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME0038151 Issued in FL
Practice address
2023 Professional Center Drive
Orange Park, FL 32073
Phone
(904) 272-2020
Fax
(904) 276-4386
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME0038151 FL Primary

Addresses

Primary practice location

2023 Professional Center Drive
Orange Park, FL 32073

Mailing address

2023 Professional Center Drive
Orange Park, FL 32073
Phone (904) 272-2020

Other identifiers 4

IdentifierTypeStateIssuer
10989OtherFLBCBS
2443399001OtherFLCIGNA
4047762OtherFLAETNA
CB1273OtherFLRAILROAD MEDICARE

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
I20080703000218 FL Practitioner - Ophthalmology 2466554944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0038151FLMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harris Wilcox and Donovan P a Ophthalmology CurrentSince Dec 31, 1988 Accepting new patients
Harris Wilcox and Donovan PA Ophthalmology CurrentSince Dec 31, 1988 Accepting new patients
Harris Wilcox and Donovan PA Ophthalmology Current Accepting new patients

Locations

1855 Eastwest Pkwy
Fleming Isle, FL 32003

11790 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 765-2020

1615 County Road 220
Ste 140
Orange Park, FL 32003
Phone (904) 276-2020

2023 Professional Center Dr
Orange Park, FL 32073
Phone 9042722020234

Interoperability endpoints

  • Direct secure messaging: jdonovan@clayeye.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1508821844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 PROFESSIONAL CENTER DRIVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-272-2020",
            "fax_number": "904-276-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 PROFESSIONAL CENTER DRIVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-272-2020",
            "fax_number": "904-276-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0038151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10989",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2443399001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4047762",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB1273",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.