Jose M Concha, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO2712 Issued in FL

Practice address

200 Southpark Blvd
Suite 208
St Augustine, FL 32086-3129

Phone

(904) 826-1900

Fax

(904) 826-1920

NPI assigned

May 31, 2006

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Foot and Ankle Wellness Center LLCGroup PAC ID 9537204151, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.94 of 100Reported as individual

Quality

90.43

Promoting interoperability

95

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jconcha743534@direct.shands.ufl.edu

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.

• Coastal Foot & Ankle Wellness Center LLC

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
  • NPI 1972834760

  FL, Podiatrist

  Medicare reassignment Care Compare group NPD
• Health Park Podiatric Foot and Ankle Clinic, Inc

  • Podiatrist
  • St Augustine, FL
  • NPI 1932430667
  NPD (past)
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  NPD (past)
• Thomas a. Tomlin M.D. PA

  • Family Medicine Physician
  • Ponte Vedra Beach, FL
  • NPI 1033430871
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1992742142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOUTHPARK BLVD",
            "address_2": "SUITE 208",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863129",
            "telephone_number": "904-826-1900",
            "fax_number": "904-826-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTHPARK BLVD",
            "address_2": "SUITE 208",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863129",
            "telephone_number": "904-826-1900",
            "fax_number": "904-826-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCHA",
        "first_name": "JOSE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340245200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Compass Conservative Counseling
• Compassionate Care Florida Inc
• Comprehensive Arthritis Spine and Pain Center
• Comprehensive Arthritis Spine and Pain Center
• Gabrielle M Compton
• Concierge Care of St. Augustine LLC
• Concierge Home Care of St Augustine LLC
• Daniel Patrick Conlin, M.D.
• Heather Brumbley Conlon, ARNP
• Connect Hearing, Inc.

• All providers in St Augustine, FL
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.