Jia Li Duan, DO
Individual provider Active NPI Family Medicine Physician · Perry, FL
NPI 1629647326 · NPPES record last updated Sep 17, 2024
Key facts
- NPI
- 1629647326
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- OS19571 (FL)
- Practice address
- 555 N Byron Butler Pkwy
Perry, FL 32347-2315 - Phone
- (850) 838-8636
- NPI assigned
- Jun 18, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tallahassee Memorial Healthcare Inc
Practice addresses (Care Compare)
555 N Byron Butler Pkwy
Perry, FL 32347-2315
Phone (850) 838-8636
Hospital & facility affiliations
- Centerwell Home Health
- NHC Homecare
- Doctors Memorial Hospital Inc
- Tallahassee Memorial Healthcare
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240715004359 | FL | Practitioner - Family Practice | 8729471685 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS19571 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tallahassee Memorial Healthcare Inc | Current | Accepting new patients | |
| Tallahassee Memorial Healthcare Inc | Current | Accepting new patients | |
| Tallahassee Memorial Healthcare Inc | Current |
Accepting new patients | |
| Tallahassee Memorial Healthcare Inc | Family Medicine | Current |
Accepting new patients |
Locations
15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105
555 N Byron Butler Pkwy
Perry, FL 32347
Phone (850) 431-5360
1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360
1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021
1301 Hodges Dr
Tallahassee, FL 32308
Phone (850) 431-5430
Interoperability endpoints
- jialiduan@tmhpp.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | OS19571 | FL | Yes |
Addresses
Primary practice location
555 N Byron Butler Pkwy
Perry, FL 32347-2315
Mailing address
1301 Hodges Dr
Tallahassee, FL 32308-4614
Phone (850) 431-5430
Other practice location 1
1301 Hodges Dr
Tallahassee, FL 32308-4614
Phone (850) 431-5430
Other providers in Perry, FL
- Doctors' Memorial Hospital Lab
- Doctors' Memorial Hospital, Inc
- Diane Dodgen
- Dr. Joseph W. Fuller
- Lindsey Nicole Driggers
- Levette Nicole Dunbar
- Dva Healthcare Renal Care, Inc.
- Laura L Early
- Terri Beth Ellison
- Macy Ely
All providers in Perry, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.