Mayo Clinic Jacksonville

Organization Active NPI Ambulatory Surgical Clinic/Center · Jacksonville, FL

NPI 1962499079 · NPPES record last updated Apr 15, 2026

Key facts

NPI
1962499079
Entity type
Organization (NPI type 2)
Primary specialty
Ambulatory Surgical Clinic/Center 261QA1903X
License
872 (FL)
Legal business name
MAYO CLINIC JACKSONVILLE
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-7355
Fax
(904) 953-1768
NPI assigned
Oct 4, 2005
Organization subpart
No

Authorized official

Name
Alice Rigdon
Title
Chief Financial Officer
Phone
(904) 953-0577

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 10

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 1,595

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,595

Medicare Care Compare: Ambulatory surgical center

Listed as
Mayo Clinic Jacksonville Dba Mayo Clinic Jacksonville ASC for G I CCN 10C0001160
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mayo Clinic Jacksonville
Jacksonville, FL · CCN 100151
Hospital Operational/Managerial Control Jan 1, 2005

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080625000071 FL Part B Supplier - Ambulatory Surgical Center 5698689297 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

Tax ID family
Mayo Clinic Jax Medical (5 organizations share this tax ID)
Part of
Mayo Clinic Jax Medical

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 872 FL Yes

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-7355

Other names

  • Mayo Clinic Jacksonville ASC for G.I. Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Other providers in Jacksonville, FL

All providers in Jacksonville, FL · Ambulatory Surgical Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.