Individual provider Active NPI

Joseph William Parks IV, M.D.

  • Plastic Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1558564591
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME 116390 Issued in FL
Practice address
14540 Old Saint Augustine Rd Ste 2391
Suite C50
Jacksonville, FL 32258-7418
Phone
(904) 262-3372
Fax
(904) 262-3306
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Plastic Surgery Physician 208200000X ME 116390 FL Primary

Addresses

Primary practice location

14540 Old Saint Augustine Rd Ste 2391
Suite C50
Jacksonville, FL 32258-7418

Mailing address

11945 San Jose Blvd Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725

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
I20131203002047 FL Practitioner - Plastic and Reconstructive Surgery 1658507280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Mercer University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

14540 Old Saint Augustine Rd
Suite 2571
Jacksonville, FL 32258-7420
Phone (904) 886-2251

Hospital & facility affiliations

  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy18
Melanoma (skin cancer) excision12
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Jan 20, 2014 Accepting new patients
North Florida Surgeons, PA CurrentSince Jan 20, 2014 Accepting new patients

Locations

1747 Baptist Clay Dr
Ste 240
Fleming Island, FL 32003
Phone (904) 214-8161

14540 Old St Augustine Rd
Ste 2391
Jacksonville, FL 32258
Phone (904) 262-3372

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

14540 Old St Augustine Rd
Ste 2571
Jacksonville, FL 32258
Phone (904) 886-2251

14546 Old St Augustine Rd
Ste 407
Jacksonville, FL 32258
Phone (904) 262-3372

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: joseph.parks.1@9109.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1558564591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-399-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 OLD SAINT AUGUSTINE RD STE 2391",
            "address_2": "SUITE C50",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322587418",
            "telephone_number": "904-262-3372",
            "fax_number": "904-262-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME 116390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.