Individual provider Active NPI

Christopher Jason Irizarry

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1851073993
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117991 Issued in FL
Practice address
3627 University Blvd S Ste 305
Jacksonville, FL 32216-4294
Phone
(904) 596-0760
Fax
(904) 398-1729
NPI assigned
Aug 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 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 PA9117991 FL Primary

Addresses

Primary practice location

3627 University Blvd S Ste 305
Jacksonville, FL 32216-4294

Mailing address

3627 University Blvd S Ste 305
Jacksonville, FL 32216-4294
Phone (904) 596-0760

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
I20240109003111 FL Practitioner - Physician Assistant 0648621136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Trauma Services LLCGroup PAC ID 3971985938, 92 clinicians

Practice addresses (Care Compare)

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (850) 862-1111

1887 Kingsley Ave
Suite 1900
Orange Park, FL 32073-4451
Phone (904) 276-2549

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 702-6111

3627 University Blvd S
Suite 305
Jacksonville, FL 32216-4294
Phone (904) 596-0760

Hospital & facility affiliations

  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9117991FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: christopher.irizarry@hca5.eclinicaldirectplus.com

Organizations & group practices 1

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1851073993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164294",
            "telephone_number": "904-596-0760",
            "fax_number": "904-398-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164294",
            "telephone_number": "904-596-0760",
            "fax_number": "904-398-1729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY",
        "first_name": "CHRISTOPHER",
        "middle_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.