Active NPI
Jason Manuel, D.P.M.
- Podiatrist
- Jacksonville, FL
National Provider Identifier
1710969217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO2551
- Practice address
- 13400 Sutton Park Dr S
Suite 1103
Jacksonville, FL 32224-0236 - Phone
- (904) 223-8818
- Fax
- (904) 223-6969
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO2551 | FL | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | P02551 | FL |
Addresses
Primary practice location
13400 Sutton Park Dr S
Suite 1103
Jacksonville, FL 32224-0236
Mailing address
13400 Sutton Park Dr S
Suite 1103
Jacksonville, FL 32224-0236
Phone (904) 223-8818
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480031776 | Other | FL | RR MEDICARE |
| 390397400 | Medicaid | FL | |
| 65442 | Other | FL | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P02551 | FL | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medlink Management Services Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rural Health Clinic/Center
- Lake Butler, FL
- NPI 1114188927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1710969217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13400 SUTTON PARK DR S",
"address_2": "SUITE 1103",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322240236",
"telephone_number": "904-223-8818",
"fax_number": "904-223-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13400 SUTTON PARK DR S",
"address_2": "SUITE 1103",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322240236",
"telephone_number": "904-223-8818",
"fax_number": "904-223-6969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANUEL",
"first_name": "JASON",
"name_prefix": "Mr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "FL",
"license": "PO2551",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "FL",
"license": "P02551",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "480031776",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "390397400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "65442",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.