Individual provider Active NPI

William Ivan Schwartz, D.O.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1659479764
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS7404 Issued in FL
Practice address
13155 Atlantic Blvd
Jacksonville, FL 32225-3125
Phone
(904) 420-6102
Fax
(904) 551-1347
NPI assigned
Sep 20, 2006
Last updated
Aug 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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 OS003774L PA
Family Medicine Physician 207Q00000X OS7404 FL Primary

Addresses

Primary practice location

13155 Atlantic Blvd
Jacksonville, FL 32225-3125

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 3

IdentifierTypeStateIssuer
57483OtherFLBLUE CROSS BLUE SHIELD
251582200MedicaidFL
45512OtherFLBCBS GROUP NUMBER

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
I20080731000554 FL Practitioner - Family Practice 2264328525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

1126 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 432-3061

1128 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 420-6105

1132 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 277-4690

1201 Monument Rd
Suite 201B
Jacksonville, FL 32225-7428
Phone (904) 727-5151

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

228 Ponte Vedra Park Dr
Suite 500
Ponte Vedra Beach, FL 32082-6611
Phone (904) 273-1180

2377 Dunn Ave
Jacksonville, FL 32218-6983
Phone (904) 648-8090

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

7751 Baymeadows Rd E
Jacksonville, FL 32256-5836

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS003774LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Apr 13, 2020 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jul 1, 2014 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jul 1, 2014 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Apr 13, 2020 Accepting new patients
Atlantic Family Medical Center of Jacksonville PL Family Medicine PastSince Mar 13, 1999 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

13155 Atlantic Blvd
Jacksonville, FL 32225
Phone (904) 221-2222

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: william.schwartz.1@4290.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1659479764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "904-221-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13155 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253125",
            "telephone_number": "904-420-6102",
            "fax_number": "904-551-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "WILLIAM",
        "middle_name": "IVAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS003774L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "57483",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251582200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "45512",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.