Individual provider Active NPI

Jodi C Picasso, M.D.

  • Pediatrics Physician
  • Pensacola, FL
National Provider Identifier
1659533065
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME115945 Issued in FL
Practice address
14 W Jordan St
Pensacola, FL 32501-1736
Phone
(850) 436-4630
Fax
(850) 436-2095
NPI assigned
Jun 26, 2008
Last updated
Apr 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X 54553 MN
Pediatrics Physician 208000000X ME115945 FL Primary

Addresses

Primary practice location

14 W Jordan St
Pensacola, FL 32501-1736

Mailing address

14 W Jordan St
Pensacola, FL 32501-1736
Phone (850) 436-4630

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
I20130604000806 FL Practitioner - Pediatric Medicine 3274701719 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME115945FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Associates LLC Pediatrics CurrentSince Jun 1, 2013 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

Interoperability endpoints

  • Direct secure messaging: drpicasso@pensacolapeds.opdirect.net
  • Direct secure messaging: jodi.picasso@avera.sdhealthlink.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1659533065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011736",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 W JORDAN ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011736",
            "telephone_number": "850-436-4630",
            "fax_number": "850-436-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICASSO",
        "first_name": "JODI",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "54553",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME115945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.