Malisa Marie Wetmore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3665 Issued in FL

Practice address

1301 Palm Ave Ste 600
Jacksonville, FL 32207-8432

Phone

(904) 202-7300

Fax

(904) 202-2754

NPI assigned

Mar 29, 2006

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist MD Anderson Cancer Physicians IncGroup PAC ID 5991932063, 115 clinicians

Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140

Merit-based Incentive Payment System (MIPS)

Final score

85.84 of 100Reported as group

Quality

73.65

Promoting interoperability

100

Improvement activities

40

Cost

74.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: mwetmore28576@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist MD Anderson Cancer Physicians Inc

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1538593124
  Medicare reassignment Care Compare group

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

• Baptist Medical Center of Nassau Inc

  • General Acute Care Hospital
  • Fernandina Beach, FL
  • NPI 1518024462
  Care Compare affiliation
• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1528029626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746654",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746654",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PALM AVE STE 600",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078432",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETMORE",
        "first_name": "MALISA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2905663-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teshaundria Weston, LMHC, CRC, NCC
• Scott Westra, D.M.D.
• Westside Surgery Center LLC
• Westwood Manor Residential Care Home LLC
• Mary Westwood
• Richard Donald Wetmore, M.D.
• Nancy Jane Wetterer, LMT, NCBTMB, CAP
• William M Wettstein, P.A.
• Amanda Wetzel, APRN
• Edward James Wetzork, D.C.

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.