Individual provider Active NPI

Jesu Misajon Trias, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1811492747
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9198218 Issued in FL
Practice address
12620 Beach Blvd Ste 13
Jacksonville, FL 32246-7130
Phone
(904) 633-0585
NPI assigned
Mar 23, 2018
Last updated
Mar 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9198218 FL Primary

Addresses

Primary practice location

12620 Beach Blvd Ste 13
Jacksonville, FL 32246-7130

Mailing address

13000 Broxton Bay Dr Apt 305
Jacksonville, FL 32218-8393
Phone (904) 859-5654

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
I20180521001766 FL Practitioner - Nurse Practitioner 8123383270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12620 Beach Blvd
Suite 13
Jacksonville, FL 32246-7130
Phone (904) 633-0585

Hospital & facility affiliations

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Apr 23, 2018 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Apr 23, 2018 Accepting new patients

Locations

12620 Beach Blvd
Ste 13
Jacksonville, FL 32246
Phone (352) 639-0760

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

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 2

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1811492747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 BROXTON BAY DR APT 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188393",
            "telephone_number": "904-859-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 BEACH BLVD STE 13",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467130",
            "telephone_number": "904-633-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIAS",
        "first_name": "JESU",
        "middle_name": "MISAJON",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9198218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.