NPIMap

Individual provider Active NPI

Christopher B Scuderi, D.O.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1760454037
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS9323 Issued in FL
Practice address
280 Dundas Dr
Jacksonville, FL 32218-5517
Phone
(904) 902-1201
Fax
(904) 902-1202
NPI assigned
Feb 2, 2006
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS9323 FL Primary

Addresses

Primary practice location

280 Dundas Dr
Jacksonville, FL 32218-5517

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090813000797 FL Practitioner - Family Practice 9133273899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

1126 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 432-3061

1128 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 420-6105

1132 S 14TH St
Fernandina Beach, FL 32034-2920
Phone (904) 277-4690

11513 N Main St
Jacksonville, FL 32218-4002
Phone (904) 751-6200

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2377 Dunn Ave
Jacksonville, FL 32218-6983
Phone (904) 648-8090

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

7451 103Rd St
Jacksonville, FL 32210-9300
Phone (904) 683-4968

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS9323FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Jun 10, 2022 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jul 1, 2009 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Jun 10, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2009 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

280 Dundas Dr
Jacksonville, FL 32218
Phone (904) 751-4906

3122 New Berlin Rd
Jacksonville, FL 32226
Phone (904) 633-0340

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

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: christopher.scuderi.1@4290.direct.athenahealth.com

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 11

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1760454037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 DUNDAS DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185517",
            "telephone_number": "904-902-1201",
            "fax_number": "904-902-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCUDERI",
        "first_name": "CHRISTOPHER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.