Individual provider Active NPI

Raymond J Mikelionis, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1639356389
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME138012 Issued in FL
Practice address
4063 Salisbury Rd # 110
Jacksonville, FL 32216-8030
Phone
(904) 440-6049
Fax
(904) 341-5624
NPI assigned
Jan 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME138012 FL Primary
Family Medicine Physician 207Q00000X G21006 CA

Addresses

Primary practice location

4063 Salisbury Rd # 110
Jacksonville, FL 32216-8030

Mailing address

1302 River St
Palatka, FL 32177-5042
Phone (386) 328-0108

Other practice location 1

1302 River St
Palatka, FL 32177-5042
Phone (386) 328-8371

Other practice location 2

201 W. Lattin Street
Hastings, FL 32145-4111
Phone (904) 692-1508

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
I20190115003415 FL Practitioner - Family Practice 4688751944 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G21006CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Care, Inc. CurrentSince Dec 9, 2018 Accepting new patients
Rural Health Care Incorporated Current Accepting new patients
Raymond J Mikelionis MD LLC Family Medicine CurrentSince Mar 23, 2026 Accepting new patients
Rural Health Care Inc CurrentSince Dec 9, 2018 Accepting new patients

Locations

4063 Salisbury Rd
#110
Jacksonville, FL 32216
Phone (904) 440-6049

4063 Salisbury Rd
Ste 110
Jacksonville, FL 32216
Phone (904) 717-9625

100 Commercial Dr
Keystone Hgts, FL 32656
Phone (352) 473-6595

1302 River St
Palatka, FL 32177
Phone (386) 328-0108

Organizations & group practices 4

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": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1639356389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 RIVER ST",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321775042",
            "telephone_number": "386-328-0108",
            "fax_number": "386-325-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4063 SALISBURY RD # 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168030",
            "telephone_number": "904-440-6049",
            "fax_number": "904-341-5624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 River St",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321775042",
            "country_code": "US",
            "telephone_number": "386-328-8371",
            "fax_number": "386-325-1086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 W. Lattin Street",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "FL",
            "postal_code": "321454111",
            "country_code": "US",
            "telephone_number": "904-692-1508",
            "fax_number": "904-692-1509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKELIONIS",
        "first_name": "RAYMOND",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-24",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME138012",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G21006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.