Michael Vincent Defazio, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

R6770 Issued in TX

Practice address

14546 Old Saint Augustine Rd Ste 407
Jacksonville, FL 32258-5473

Phone

(904) 262-3372

Fax

(904) 262-3306

NPI assigned

Apr 9, 2012

Sex

Male

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 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive Surgery

Education

University of Miami, LM Miller School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Merit-based Incentive Payment System (MIPS)

Final score

81.79 of 100Reported as group

Quality

64.42

Promoting interoperability

100

Improvement activities

40

Cost

74.88

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: michael.defazio.1@9109.direct.athenahealth.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.

• North Florida Surgeons, PA

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1912953290
  Medicare reassignment Care Compare group NPD
• North Florida Surgeons, PA

  • Orthopaedic Surgery Physician
  • Gulf Breeze, FL
  • NPI 1871442053
  NPD

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

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1821354325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD STE 407",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585473",
            "telephone_number": "904-262-3372",
            "fax_number": "904-262-3306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Reservoir Rd NW",
            "address_2": "Dept of Plastic Surgery",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200072113",
            "country_code": "US",
            "telephone_number": "202-444-1233",
            "fax_number": "202-444-7422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Pressler St Unit 1488",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "713-794-1247",
            "fax_number": "713-794-5492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "MICHAEL",
        "middle_name": "VINCENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "R6770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8JM813",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387059402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387059401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deerwood Dental Group
• Deerwood Lake Chiropractic
• Deborah L Dees, MA, CCC-SLP
• Nina Lynne Deese, BCBA
• Jessica Defazio, PA-C
• Define Wellness Chiropractic and Functional Medicine
• Robert Deflorio
• Kimberly Elizabeth Degelmann
• Catherine Abbie Degesys, M.D.
• Kathryn Tyrrell Degoursey, PA-C

• Plastic and Reconstructive Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.