Individual provider Active NPI

Austin Jeffrey Gillette, DO

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1750918272
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS19546 Issued in FL
Practice address
230 Village Commons Dr
St Augustine, FL 32092-4545
Phone
(904) 940-1441
Fax
(904) 390-7463
NPI assigned
Mar 25, 2020
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS19546 FL Primary
Sports Medicine (Family Medicine) Physician 207QS0010X OS19546 FL

Addresses

Primary practice location

230 Village Commons Dr
St Augustine, FL 32092-4545

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: 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
I20240613001492 FL Practitioner - Family PracticePractitioner - Sports Medicine 1557781762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Philadelphia College of Osteopathic Medicine, 2020
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)

230 Village Commons Dr
St Augustine, FL 32092-4545
Phone (904) 940-1441

Hospital & facility affiliations

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 lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS19546FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients
Baptist Primary Care Inc. Family Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

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

230 Village Commons Dr
Saint Augustine, FL 32092
Phone (904) 940-1441

Interoperability endpoints

  • Direct secure messaging: agillette174008@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1750918272",
    "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": "230 VILLAGE COMMONS DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320924545",
            "telephone_number": "904-940-1441",
            "fax_number": "904-390-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "AUSTIN",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19546",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS19546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.