NPIMap

Individual provider Active NPI

Peter Jansen, MD

  • Family Medicine Physician
  • Fleming Island, FL
National Provider Identifier
1689634172
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME69804 Issued in FL
Practice address
2310 Village Square Pkwy Ste 200
Fleming Island, FL 32003-6351
Phone
(904) 264-6404
Fax
(904) 264-6884
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME69804 FL Primary

Addresses

Primary practice location

2310 Village Square Pkwy Ste 200
Fleming Island, FL 32003-6351

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032

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
I20040824001150 FL Practitioner - Family Practice 4486628500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

2349 Village Square Pkwy
Suite 110
Fleming Island, FL 32003-4319
Phone (904) 264-6404

Hospital & facility affiliations

  • Baptist Home Health Care by Bayada Home health agency, Jacksonville, FL, CCN 107482
  • Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
  • Choice Matters Home Healthcare Inc Home health agency, Jacksonville, FL, CCN 683129
  • Enhabit Home Health Home health agency, Jacksonville, FL, CCN 108148
  • Ascension Health at Home of Florida 1 LLC Home health agency, Jacksonville, FL, CCN 683147
  • Community Hospice of Northeast Florida Inc Hospice, Jacksonville, FL, CCN 101500
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Sep 1, 2018 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Sep 1, 2018 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Sep 11, 2022 Accepting new patients

Locations

2310 Village Square Pkwy
Ste 200
Fleming Island, FL 32003
Phone (904) 264-6404

2310 Village Square Pkwy
Ste 201
Fleming Island, FL 32003
Phone (904) 264-6404

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

2349 Village Square Pkwy
Ste 110
Orange Park, FL 32003
Phone (904) 264-6404

Interoperability endpoints

  • Direct secure messaging: pjansen28167@baptisthealthsystemjacksonville.direct-ci.com

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 12

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1689634172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 VILLAGE SQUARE PKWY STE 200",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320036351",
            "telephone_number": "904-264-6404",
            "fax_number": "904-264-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME69804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.