Individual provider Active NPI

Francesca Nicoloso, PA

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1710319843
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107277 Issued in FL
Practice address
3625 University Blvd S
Jacksonville, FL 32216-4207
Phone
(904) 399-6111
NPI assigned
Jul 31, 2013
Last updated
Sep 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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 PA9107277 FL Primary

Addresses

Primary practice location

3625 University Blvd S
Jacksonville, FL 32216-4207

Mailing address

18167 US Highway 19 N Ste 650
Clearwater, FL 33764-6576
Phone (800) 507-8874

Other identifiers 2

IdentifierTypeStateIssuer
003161169AMedicaidGA
009927400MedicaidFL

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
I20131105000566 FL Practitioner - Physician Assistant 6800021551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

655 W 8TH St
Jacksonville, FL 32231-6511
Phone (904) 244-6340

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Apr 27, 2015 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Apr 27, 2015 Accepting new patients
Kite Emergency Physicians LLC Past Accepting new patients
Florida Em-I Medical Services, PA Physician Assistant Past Accepting new patients
Kingsley Avenue Emergency Physicians LLC Past Accepting new patients

Locations

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

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

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Interoperability endpoints

  • Direct secure messaging: fnicoloso180822@direct.shands.ufl.edu

Organizations & group practices 7

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1710319843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18167 US HIGHWAY 19 N STE 650",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646576",
            "telephone_number": "800-507-8874",
            "fax_number": "727-536-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-399-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLOSO",
        "first_name": "FRANCESCA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003161169A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009927400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.