Jaclyn Tyo Meldrum, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9103502 Issued in FL

Practice address

5191 First Coast Tech Pkwy FL 3
Jacksonville, FL 32224-0609

Phone

(904) 223-3321

Fax

(904) 223-2169

NPI assigned

Apr 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jaclyn Michelle Tyo Former name

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

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Spine Center PAGroup PAC ID 6901890300, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Ascension St Vincent's Clay County Hospital, Middleburg, FL, CCN 100321

Merit-based Incentive Payment System (MIPS)

Final score

90.75 of 100Reported as group

Quality

88.19

Promoting interoperability

100

Improvement activities

40

Cost

80.96

Merit-based Incentive Payment System (MIPS)

Final score

80.97 of 100Reported as group

Quality

70.19

Promoting interoperability

98

Improvement activities

40

Cost

68.04

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaclyn.meldrum@jspc.eclinicaldirectplus.com

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.

• Jacksonville Spine Center PA

  dba Jax Spine & Pain Centers

  • Pain Medicine (Anesthesiology) Physician
  • Jacksonville, FL
  • NPI 1881643757
  Medicare reassignment Care Compare group NPD
• Southeast Orthopedic Specialists, LLC

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
  • NPI 1629025820
  Medicare reassignment NPD
• Jacksonville Spine Center PA

  dba Centurion Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Altamonte Springs, FL
  • NPI 1861197071
  NPD
• Southeast Orthopedic Specialists, LLC

  • Durable Medical Equipment & Medical Supplies
  • Saint Johns, FL
  • NPI 1538952379
  NPD
• Georgia Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Waycross, GA
  • NPI 1134769714
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• St. Vincent's Medical Center-Clay County, Inc.

  dba Ascension St. Vincent's Clay County

  • General Acute Care Hospital
  • Middleburg, FL
  • NPI 1457690471
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1811950272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Park St Ste B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044518",
            "country_code": "US",
            "telephone_number": "904-223-3321",
            "fax_number": "904-223-2169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELDRUM",
        "first_name": "JACLYN",
        "middle_name": "TYO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292340800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "TYO",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Crystal Mejia
• Idania Mejias-Rodriguez, M.D.
• Arianna De la Caridad Mejias
• Kaitlyn Melamed
• Melchor M Carbonell, MD, PA
• Michael Meldrum
• Cheryl A. Mele, APRN
• Kandie Ayana Melendez-Ortez
• Luis Melendez, CFA
• Shajitha Melethil, M.B.B.S.

• Surgical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.