Individual provider Active NPI

Andrew Joseph Hogan, M.D.

  • Family Medicine Physician
  • Ponte Vedra, FL
National Provider Identifier
1902245103
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME147276 Issued in FL
Practice address
351 Town Plaza Ave Ste 105a
Ponte Vedra, FL 32081-5178
Phone
(904) 819-3233
Fax
(904) 456-0819
NPI assigned
Jun 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME147276 FL Primary

Addresses

Primary practice location

351 Town Plaza Ave Ste 105a
Ponte Vedra, FL 32081-5178

Mailing address

PO Box 3266
Saint Augustine, FL 32085-3266

Other practice location 1

554 Keily Street
Bureau Med Surg; Attn: Credentialing & Privileging
Jacksonville, FL 32212
Phone (850) 292-8811

Other practice location 2

120 Palencia Village Dr Ste 107
Saint Augustine, FL 32095-8553
Phone (904) 819-3200

Other practice location 3

33 Old Kings Rd N Ste 3
Palm Coast, FL 32137-8238
Phone (386) 445-1100

Other practice location 4

201 Health Park Blvd Ste 215
Saint Augustine, FL 32086-5797
Phone (904) 824-3777

Other practice location 5

70 Turin Ter Ste 100
Saint Augustine, FL 32092-0849
Phone (904) 819-1200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316000239 FL Practitioner - Family Practice 1557677747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Florida State University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

351 Town Plaza Ave
Ponte Vedra, FL 32081-5179

Hospital & facility affiliations

  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as apm
Quality
77.66
Promoting interoperability
70.54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Professional Health Care Services, Inc. CurrentSince Mar 8, 2021 Accepting new patients
Flagler Professional Health Care Services, Inc. Family Medicine CurrentSince Mar 8, 2021 Accepting new patients
Villages Regional Hospital Physician Services LLC CurrentSince May 1, 2025 Accepting new patients

Locations

33 Old Kings Rd N
Ste 3
Palm Coast, FL 32137
Phone (386) 445-1100

351 Town Plaza Ave
Ste 105A
Ponte Vedra, FL 32081
Phone (904) 819-3233

120 Palencia Village Dr
Ste 107
Saint Augustine, FL 32095
Phone (904) 819-3200

120 Palencia Village Dr
Saint Augustine, FL 32095
Phone (904) 819-3200

201 Health Park Blvd
Ste 215
St Augustine, FL 32086
Phone (904) 373-1177

70 Turin Ter
Ste 100
St Augustine, FL 32092
Phone (904) 819-1101

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Interoperability endpoints

  • Direct secure messaging: ahogan741084@direct.shands.ufl.edu

Organizations & group practices 3

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 5

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": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1902245103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3266",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320853266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 TOWN PLAZA AVE STE 105A",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815178",
            "telephone_number": "904-819-3233",
            "fax_number": "904-456-0819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "554 Keily Street",
            "address_2": "Bureau Med Surg; Attn: Credentialing & Privileging",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32212",
            "country_code": "US",
            "telephone_number": "850-292-8811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Palencia Village Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320958553",
            "country_code": "US",
            "telephone_number": "904-819-3200",
            "fax_number": "904-819-3201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33 Old Kings Rd N Ste 3",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321378238",
            "country_code": "US",
            "telephone_number": "386-445-1100",
            "fax_number": "386-445-1408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Health Park Blvd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320865797",
            "country_code": "US",
            "telephone_number": "904-824-3777",
            "fax_number": "904-824-6050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Turin Ter Ste 100",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320920849",
            "country_code": "US",
            "telephone_number": "904-819-1200",
            "fax_number": "904-819-1199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME147276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

Verify at the official NPI Registry.