Nicholas D a Peterkin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME114121 Issued in FL

Practice address

832 A1A N Ste 6
Ponte Vedra, FL 32082-3216

Phone

(904) 834-3793

Fax

(904) 390-7435

NPI assigned

Aug 2, 2010

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 1

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

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Home Health Care by Bayada Home health agency, Jacksonville, FL, CCN 107482
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

Merit-based Incentive Payment System (MIPS)

Final score

95.44 of 100Reported as apm

Quality

84.21

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npeterkin28162@baptisthealthsystemjacksonville.direct-ci.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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529
  Medicare reassignment Care Compare group NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Ponte Vedra Beach, FL
  • NPI 1184246670
  NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1427239474
  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
• Baybap, LLC.

  dba Baptist Home Health Care by BAYADA

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1023612884
  Care Compare affiliation
• Memorial Healthcare Group Inc

  dba HCA Florida Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • 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": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1912211905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 A1A N STE 6",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320823216",
            "telephone_number": "904-834-3793",
            "fax_number": "904-390-7435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERKIN",
        "first_name": "NICHOLAS",
        "middle_name": "D A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-02",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME114121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01346898",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Catharine Penn, ARNP
• Andria U Pennant, MD
• Jonathan Isaiah Perez-Guerra
• Matthew Perez-Smith
• Susana Perry, D.M.D.
• Alexis Piarulli, D.C.
• Adam Podraza
• Sarah Poe, PT, DPT
• Ponte Vedra Beach Chiropractic Inc
• Ponte Vedra Behavioral Health LLC

• Family Medicine Physician in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.