Individual provider Active NPI

Emma E Atwell, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1821640624
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9112134 Issued in FL
Practice address
3627 University Blvd S Ste 500
Jacksonville, FL 32216-7405
Phone
(904) 399-5678
Fax
(904) 399-8488
NPI assigned
Jul 11, 2019
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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 PA9112134 FL Primary

Addresses

Primary practice location

3627 University Blvd S Ste 500
Jacksonville, FL 32216-7405

Mailing address

3627 University Blvd S Ste 500
Jacksonville, FL 32216-7405
Phone (904) 399-5678

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
I20191018000402 FL Practitioner - Physician Assistant 6608107800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2018
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)

3627 University Blvd S
Suite 500
Jacksonville, FL 32216-7405
Phone (904) 858-1912

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9112134FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Jan 1, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

1747 Baptist Clay Dr
Ste 230
Fleming Island, FL 32003
Phone (904) 592-1068

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

14546 Old St Augustine Rd
Ste 401
Jacksonville, FL 32258
Phone (904) 268-5366

3627 University Blvd S
Ste 500
Jacksonville, FL 32216
Phone (904) 396-2804

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

Interoperability endpoints

  • Direct secure messaging: emma.atwell.1@9109.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1821640624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 500",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322167405",
            "telephone_number": "904-399-5678",
            "fax_number": "904-399-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 500",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322167405",
            "telephone_number": "904-399-5678",
            "fax_number": "904-399-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWELL",
        "first_name": "EMMA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.