Individual provider Active NPI

Thomas Daniel Padilla

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1689540312
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11040259 Issued in FL
Practice address
15255 Max Leggett Pkwy
Jacksonville, FL 32218-7273
Phone
(904) 244-9092
Fax
(904) 244-9493
NPI assigned
Oct 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X APRN11040259 FL Primary

Addresses

Primary practice location

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7273

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251120000687 FL Practitioner - Nurse Practitioner 4082106851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11040259FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Multi-Specialty CurrentSince Oct 21, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Multi-Specialty Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 21, 2025 Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

15255 Max Leggett Pkwy
Jacksonville, FL 32218
Phone (904) 383-1000

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

Hospital & facility affiliations 2

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": "1760054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1689540312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15255 MAX LEGGETT PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187273",
            "telephone_number": "904-244-9092",
            "fax_number": "904-244-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "THOMAS",
        "middle_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-10",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11040259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.