- Medicare Primary Care in Jacksonville, FL

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is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Jacksonville, Florida. The current practice location for is 3003 Claire Ln Ste 100, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 226-7229. The mailing address for is 3003 Claire Ln Ste 100, Jacksonville, Florida and phone number is (904) 204-6585.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1184215006. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (904) 226-7229.

Contact Information

3003 Claire Ln Ste 100
Jacksonville
FL 32223-6667
(904) 226-7229
Not Available

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityClinic/Center
Location3003 Claire Ln Ste 100, Jacksonville, Florida
Authorized Official Name and PositionOmar Jishi Moore (MD/OWNER)
Authorized Official Contact8508558764
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

3003 Claire Ln Ste 100
Jacksonville
FL 32223-6667

Ph: (904) 204-6585
3003 Claire Ln Ste 100
Jacksonville
FL 32223-6667

Ph: (904) 226-7229

NPI Details:

NPI Number1184215006
Provider Enumeration Date02/02/2021
Last Update Date07/24/2024

Medicare PECOS Information:

Medicare PECOS PAC ID5395150437
Medicare Enrollment IDO20210223000985

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184215006NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Secondary
2084N0400XPsychiatry & Neurology - Neurology (* (Not Available))Secondary
2084N0600XPsychiatry & Neurology - Clinical Neurophysiology (* (Not Available))Secondary
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameSharon L Diamond
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215232533
PECOS PAC ID: 5294918827
Enrollment ID: I20110321000025
Provider NameSana Chaudhry
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1164866521
PECOS PAC ID: 0042515033
Enrollment ID: I20160908001362
Provider NameOmar Jishi Moore
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1487072245
PECOS PAC ID: 2769780188
Enrollment ID: I20190530000362
Provider NameSteven Trisker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124514534
PECOS PAC ID: 0941552913
Enrollment ID: I20200930000203
Provider NameNelly Choudja
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508516113
PECOS PAC ID: 7113395385
Enrollment ID: I20221118000927
Provider NameMateusz Lapucha
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1992191266
PECOS PAC ID: 1355634361
Enrollment ID: I20230504000993
Provider NameAngel L Valladares
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497267686
PECOS PAC ID: 5597919472
Enrollment ID: I20230703002076
Provider NameMolly Ann Poucher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154006948
PECOS PAC ID: 0648639807
Enrollment ID: I20230706000703
Provider NameOritza Haedo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962185017
PECOS PAC ID: 8527422955
Enrollment ID: I20230918002964
Provider NamePatricia Siatta Tulay-robinson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780927772
PECOS PAC ID: 2062864663
Enrollment ID: I20240119000430
Provider NameJason Edward Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932943313
PECOS PAC ID: 6507303310
Enrollment ID: I20240730000121
Provider NamePatricia Conkling
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356332365
PECOS PAC ID: 7315933033
Enrollment ID: I20241121004558

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.