NPIMap

Individual provider Active NPI

Jennifer Diane Becker, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1649577115
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101817 Issued in FL
Practice address
915 W Monroe St Ste 200
Jacksonville, FL 32204-1177
Phone
(904) 384-2240
Fax
(904) 486-2314
NPI assigned
Feb 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9101817 FL Primary

Addresses

Primary practice location

915 W Monroe St Ste 200
Jacksonville, FL 32204-1177

Mailing address

915 W Monroe St Ste 200
Jacksonville, FL 32204-1177
Phone (904) 384-2240

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
I20130613000702 FL Practitioner - Physician Assistant 3274772728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Florida Endocrine and Diabetes Associates PAGroup PAC ID 7214823640, 79 clinicians

Practice addresses (Care Compare)

1375 Roberts Dr
Suite 206
Jacksonville Beach, FL 32250-3209
Phone (904) 384-2240

1635 Eagle Harbor Pkwy
Suite 5
Fleming Island, FL 32003-4827
Phone (904) 384-2240

600 Plantation Island Dr S
Suite 1
St Augustine, FL 32080-6010
Phone (904) 384-2240

Hospital & facility affiliations

  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
  • Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363
  • HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9101817FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North East Florida Endocrine and Diabetes Assoc PA CurrentSince Feb 8, 2016 Accepting new patients

Locations

915 W Monroe St
Ste 200
Jacksonville, FL 32204

1375 Roberts Dr
Ste 206
Jax Bch, FL 32250
Phone (904) 247-1456

600 Plantation Island Dr S
Ste 1
St Augustine, FL 32080
Phone (904) 224-5108

Interoperability endpoints

  • Direct secure messaging: jbecker742655@direct.shands.ufl.edu
  • Direct secure messaging: jenniferbecker@nfed.allscriptsdirect.net

Organizations & group practices 3

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 6

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": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1649577115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-18",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.