Individual provider Active NPI

Jerome Edward Daniel, DO

  • Emergency Medicine Physician
  • Stuart, FL
National Provider Identifier
1699208470
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS17766 Issued in FL
Practice address
200 SE Hospital Ave
Stuart, FL 34994-2346
Phone
(772) 287-5200
NPI assigned
Apr 7, 2017
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X OS17766 FL Primary

Addresses

Primary practice location

200 SE Hospital Ave
Stuart, FL 34994-2346

Mailing address

12836 Woodmill Dr
Palm Beach Gardens, FL 33418-8943
Phone (541) 913-9105

Other practice location 1

1800 SE Tiffany Ave
Port St Lucie, FL 34952-7521
Phone (541) 913-9105

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
I20210713001494 FL Practitioner - Emergency Medicine 1153723184 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Contracting Services LLCGroup PAC ID 3971417825, 404 clinicians

Practice addresses (Care Compare)

200 Sehospital Ave
Stuart, FL 34994
Phone (772) 287-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS17766FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Single Specialty CurrentSince Apr 1, 2023 Accepting new patients
Paragon Contracting Services LLC Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Paragon Emergency Services LLC Single Specialty CurrentSince Jan 22, 2024 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Organizations & group practices 4

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1699208470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12836 WOODMILL DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334188943",
            "telephone_number": "541-913-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-287-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 SE Tiffany Ave",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349527521",
            "country_code": "US",
            "telephone_number": "541-913-9105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "JEROME",
        "middle_name": "EDWARD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS17766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.