Individual provider Active NPI

Amy Christine Simmens, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1821238312
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104940 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(813) 846-6291
NPI assigned
Feb 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104940 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other practice location 1

820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205
Phone (904) 202-3860

Other identifiers 2

IdentifierTypeStateIssuer
BP546TOtherFLMEDICARE - INDIVIDUAL
GR172AOtherFLMEDICARE - GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asimmens1996825@ehrdirect.mayoclinicmsg.org

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
I20090429000124 FL Practitioner - Physician Assistant 8123176294 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Aug 18, 2023 Accepting new patients
Baptist Primary Care Inc CurrentSince Jun 18, 2017 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Sep 3, 2013 Accepting new patients
Baptist Primary Care Inc. CurrentSince Jun 18, 2017 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Aug 18, 2023 Accepting new patients
Symphony Specialty Group, LLC PastSince Jul 17, 2023 Accepting new patients
Baptist Primary Care Inc Physician Assistant Past Accepting new patients
Quality Drive Emergency Physicians LLC Past Accepting new patients
Sabal Palm Emergency Physicians Past Accepting new patients

Locations

45465 Fifth Ave
Callahan, FL 32011
Phone (904) 879-4544

820 Prudential Dr
Ste 304
Jacksonville, FL 32207
Phone (904) 202-3860

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

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

Interoperability endpoints

  • Direct secure messaging: amy.simmens.1@8967.direct.athenahealth.com

Organizations & group practices 9

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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1821238312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "813-846-6291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 Prudential Dr Ste 304",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078205",
            "country_code": "US",
            "telephone_number": "904-202-3860",
            "fax_number": "904-202-3846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMENS",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - INDIVIDUAL",
            "identifier": "BP546T",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - GROUP",
            "identifier": "GR172A",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asimmens1996825@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.