Robert Micah Pastula

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101272142 Issued in VA

Practice address

2080 Child St
Jacksonville, FL 32214-5000

Phone

(239) 849-8386

NPI assigned

Mar 23, 2017

Last updated

Nov 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1619408408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST DEPT 5000",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145000",
            "telephone_number": "239-849-8386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 8th St W",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32209",
            "country_code": "US",
            "telephone_number": "239-849-8386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASTULA",
        "first_name": "ROBERT",
        "middle_name": "MICAH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101272142",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TME9",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.tricareonline.com/",
            "affiliation": "N",
            "endpointDescription": "Tricare Online",
            "address_1": "2080 Child St",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322145005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.tricareonline.com/",
            "affiliation": "N",
            "endpointDescription": "Tricare Online",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "Hospital Americano Base Naval de Rota",
            "address_2": "Apartado de Correos 33",
            "city": "Rota",
            "state": "Cadiz",
            "country_code": "ES",
            "postal_code": "11530",
            "country_name": "Spain",
            "address_type": "FGN"
        }
    ],
    "other_names": []
}

• Passionate Hands LLC
• Passport Health Holdings, LLC (Passport Health)
• Pastoral Counseling Services, Inc. (Pastoral Counseling Services)
• Madysen Ann Pastorello-Bailey, BEHAVIOR TECHNICIAN
• Craig T Pastuck, M.S., CCC-SLP
• Deepak Kumar Pasupula, MD, MPH
• Edith Liliana Patarroyo Rodriguez, MD
• Gene R Patch, DMD
• Michael Edward Patch, D.D.S.
• Sherry Lynn Patchan, RBT

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.