NPIMap

Individual provider Active NPI

Jacob Sterling Gardner, MD

  • Internal Medicine Physician
  • Sarasota, FL
National Provider Identifier
1639674047
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME149653 Issued in FL
Practice address
3333 Cattlemen Rd Ste 208
Sarasota, FL 34232-6058
Phone
(941) 379-5121
Fax
(941) 379-4239
NPI assigned
Mar 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME149653 FL Primary

Addresses

Primary practice location

3333 Cattlemen Rd Ste 208
Sarasota, FL 34232-6058

Mailing address

3333 Cattlemen Rd Ste 208
Sarasota, FL 34232-6058
Phone (941) 379-5121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jacob.Gardner@img.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210625000130 FL Practitioner - Internal Medicine 5294084661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Florida State University College of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Nokomis Physical Therapy LLCGroup PAC ID 8628240843, 104 clinicians
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Practice addresses (Care Compare)

109 Laurel Rd E
Nokomis, FL 34275-5233
Phone (941) 375-8734

3333 Cattlemen Rd
Suite 208
Sarasota, FL 34232-6058
Phone (941) 379-5121

Hospital & facility affiliations

  • Mederi Caretenders Home health agency, Sarasota, FL, CCN 108171
  • Patients First Home Care LLC Home health agency, Sarasota, FL, CCN 687176
  • Aveanna Home Health Home health agency, Sarasota, FL, CCN 108480
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • Empath Home Health Home health agency, Fort Myers, FL, CCN 109786
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359
  • HCA Florida Sarasota Doctors Hospital Hospital, Sarasota, FL, CCN 100166
  • Sunnyside Nursing Home Nursing home, Sarasota, FL, CCN 106053

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME149653FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

3333 Cattlemen Rd
Ste 208
Sarasota, FL 34232
Phone (941) 379-5121

2881 Hyde Park St
Sarasota, FL 34239
Phone (941) 366-2460

Interoperability endpoints

  • Direct secure messaging: jacob.gardner@img.directbygreenway.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 9

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1639674047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CATTLEMEN RD STE 208",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326058",
            "telephone_number": "941-379-5121",
            "fax_number": "941-379-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CATTLEMEN RD STE 208",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326058",
            "telephone_number": "941-379-5121",
            "fax_number": "941-379-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JACOB",
        "middle_name": "STERLING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME149653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jacob.Gardner@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3333 Cattlemen Rd Ste 208",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342326058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.