Individual provider Active NPI

Michael P Juneau, PA-C

  • Surgical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1821077173
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9108713 Issued in FL
Practice address
836 Prudential Dr
Ste 1804
Jacksonville, FL 32207-8345
Phone
(904) 398-3888
Fax
(904) 400-6675
NPI assigned
Jan 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9108713 FL Primary

Addresses

Primary practice location

836 Prudential Dr
Ste 1804
Jacksonville, FL 32207-8345

Mailing address

1824 King St
Ste 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

Other identifiers 2

IdentifierTypeStateIssuer
003181725AMedicaidGA
015882500MedicaidFL

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
I20151112001628 FL Practitioner - Physician Assistant 6103891304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiothoracic and Vascular Surgical Associates PAGroup PAC ID 5395725188, 85 clinicians

Practice addresses (Care Compare)

1824 King St
Suite 200
Jacksonville, FL 32204-4736
Phone (904) 384-3343

836 Prudential Dr
Suite 1804
Jacksonville, FL 32207-8345
Phone (904) 398-3888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9108713FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 31, 2016 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 31, 2016 Accepting new patients
State of Maine Past Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

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

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

Interoperability endpoints

  • Direct secure messaging: michaeljuneau@cvsapa.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1137196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1821077173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST",
            "address_2": "STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-384-3343",
            "fax_number": "904-400-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR",
            "address_2": "STE 1804",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078345",
            "telephone_number": "904-398-3888",
            "fax_number": "904-400-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNEAU",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-14",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9108713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181725A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015882500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.