Individual provider Active NPI

Adrian Andrews, PA

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1689608598
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103249 Issued in FL
Practice address
14300 Fang Dr
BLDG #3
Jacksonville, FL 32218-7933
Phone
(954) 696-2828
NPI assigned
Jul 10, 2006
Last updated
Jun 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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 PA9103249 FL Primary

Addresses

Primary practice location

14300 Fang Dr
BLDG #3
Jacksonville, FL 32218-7933

Mailing address

13000 Broxton Bay Dr
# 308
Jacksonville, FL 32218-8390
Phone (954) 696-2828

Other identifiers 2

IdentifierTypeStateIssuer
U7403TOtherFLRAILROAD MEDICARE
292544300MedicaidFL

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
I20060509000343 FL Practitioner - Physician Assistant 8325059181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006882GAMDOccupational Therapist
PA9103249FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Apr 20, 2020 Accepting new patients
Jax Mobile Urgent Care Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Apr 20, 2020 Accepting new patients
Advanced Pediatric Specialists LLC Past Accepting new patients
FMC Emergency Solutions LLC Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1689608598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 BROXTON BAY DR",
            "address_2": "# 308",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188390",
            "telephone_number": "954-696-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 FANG DR",
            "address_2": "BLDG #3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187933",
            "telephone_number": "954-696-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "ADRIAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "U7403T",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292544300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.