Individual provider Active NPI

Julie E. Thomas, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1700179207
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105778 Issued in FL
Practice address
1639 Atlantic Blvd Ste 100
Jacksonville, FL 32207-3346
Phone
(866) 400-3376
Fax
(904) 354-0673
NPI assigned
May 17, 2011
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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 PA9105778 FL Primary

Addresses

Primary practice location

1639 Atlantic Blvd Ste 100
Jacksonville, FL 32207-3346

Mailing address

151 Southhall LN Ste 300
Maitland, FL 32751-7172
Phone (866) 400-3376

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
I20150121002032 FL Practitioner - Physician Assistant 9133443187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaches Dermatology, P.a.Group PAC ID 9133190549, 15 clinicians

Practice addresses (Care Compare)

103 -B Solana Rd
Ponte Vedra Beach, FL 32082-2231

103 Solana Rd
Ponte Vedra Beach, FL 32082-2231
Phone (904) 273-2717

1639 Atlantic Blvd
Suite 100
Jacksonville, FL 32207-3346
Phone (904) 354-4488

Merit-based Incentive Payment System (MIPS)

Final score
90.79 of 100Reported as group
Quality
84.04
Promoting interoperability
100
Improvement activities
40
Cost
85.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105778FLMDPhysician Assistant

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": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1700179207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "866-400-3376",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 ATLANTIC BLVD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073346",
            "telephone_number": "866-400-3376",
            "fax_number": "904-354-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JULIE",
        "middle_name": "E.",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.