St Vincent's Full Service Urgent Care, Llc - Medicare Primary Care in Jacksonville, FL

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St Vincent's Full Service Urgent Care, Llc is a medicare enrolled primary clinic (Clinic/center - Occupational Medicine) in Jacksonville, Florida. The current practice location for St Vincent's Full Service Urgent Care, Llc is 10503 San Jose Blvd, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 379-1203. The mailing address for St Vincent's Full Service Urgent Care, Llc is 4205 Belfort Rd Ste 4015, Jacksonville, Florida and phone number is () -.

St Vincent's Full Service Urgent Care, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1750672051. 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) 379-1203.

Contact Information

St Vincent's Full Service Urgent Care, Llc
10503 San Jose Blvd
Jacksonville
FL 32257
(904) 379-1203
(904) 379-9282

Map and Direction


Primary Care Clinic Profile

Full NameSt Vincent's Full Service Urgent Care, Llc
SpecialityClinic/Center
Location10503 San Jose Blvd, Jacksonville, Florida
Authorized Official Name and PositionAndrea Mendoza (CHIEF REV. CYCLE SPECIALIST)
Authorized Official Contact9044506045
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
St Vincent's Full Service Urgent Care, Llc
4205 Belfort Rd Ste 4015
Jacksonville
FL 32216-3623

Ph: () -		St Vincent's Full Service Urgent Care, Llc
10503 San Jose Blvd
Jacksonville
FL 32257

Ph: (904) 379-1203

NPI Details:

NPI Number1750672051
Provider Enumeration Date04/21/2011
Last Update Date07/23/2018

Medicare PECOS Information:

Medicare PECOS PAC ID4183879364
Medicare Enrollment IDO20130220000322

Medical Identifiers

Medical identifiers for St Vincent's Full Service Urgent Care, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1750672051NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Secondary
261QU0200XClinic/center - Urgent Care (* (Not Available))Secondary
261QX0100XClinic/center - Occupational Medicine (* (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. St Vincent's Full Service Urgent Care, Llc acts as a billing entity for following providers:
Provider NameNancy P Medina
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1538127808
PECOS PAC ID: 2264407550
Enrollment ID: I20040831000321
Provider NameMartha Sanchez Silva
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851482681
PECOS PAC ID: 5799740007
Enrollment ID: I20041129000660
Provider NameWillie A Pennick
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1568426302
PECOS PAC ID: 2365471711
Enrollment ID: I20050806000017
Provider NameDale Tucker
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1720024425
PECOS PAC ID: 4385655125
Enrollment ID: I20060509000179
Provider NameRobert M Chapa
Provider TypePractitioner - Preventive Medicine
Provider IdentifiersNPI Number: 1588780928
PECOS PAC ID: 7810068178
Enrollment ID: I20080616000103
Provider NameFarid Ahmed
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1205018843
PECOS PAC ID: 0749355295
Enrollment ID: I20080818000440
Provider NameW Augenstein
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1013975507
PECOS PAC ID: 1951468677
Enrollment ID: I20090325000370
Provider NameAndrew Schare
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1396771119
PECOS PAC ID: 6305903733
Enrollment ID: I20090330000227
Provider NameWilliam Dietrich
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1952397036
PECOS PAC ID: 6002973443
Enrollment ID: I20090330000313
Provider NameBradley Berger
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1144278011
PECOS PAC ID: 2264568740
Enrollment ID: I20100414000276
Provider NameRalph Badanowski
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1205894508
PECOS PAC ID: 3274422696
Enrollment ID: I20100414000558
Provider NamePhilip R Sharp
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1548204282
PECOS PAC ID: 7517094105
Enrollment ID: I20100430000361
Provider NameAlex Brown
Provider TypePractitioner - Sports Medicine
Provider IdentifiersNPI Number: 1700902434
PECOS PAC ID: 0749472900
Enrollment ID: I20101006000265
Provider NamePaul Lucey
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1013959709
PECOS PAC ID: 8426246141
Enrollment ID: I20101222000639
Provider NameRick Albarran
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902188923
PECOS PAC ID: 1951574797
Enrollment ID: I20111024000341
Provider NamePaul Moir
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1972600054
PECOS PAC ID: 5092972497
Enrollment ID: I20120213000284
Provider NameEmily Katherine Begley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508183435
PECOS PAC ID: 7315105749
Enrollment ID: I20120215000029
Provider NameMary P Freeman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457633745
PECOS PAC ID: 3476709635
Enrollment ID: I20120803000740
Provider NameRobert P Martin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437116464
PECOS PAC ID: 8628226156
Enrollment ID: I20120907000146
Provider NameDina Fedor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164728010
PECOS PAC ID: 0345414892
Enrollment ID: I20120928000084
Provider NameCheryl L Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356690721
PECOS PAC ID: 0749438968
Enrollment ID: I20121031000650
Provider NameLauren W Bell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144564170
PECOS PAC ID: 0941454599
Enrollment ID: I20130206000411
Provider NameErica J Humbert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265879563
PECOS PAC ID: 8921248311
Enrollment ID: I20130708000591
Provider NameSararose E Carver
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316387590
PECOS PAC ID: 8426299033
Enrollment ID: I20130724000629
Provider NameAmbar M Patel
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1366649758
PECOS PAC ID: 3779725569
Enrollment ID: I20130807000313
Provider NameMaria Del Carmen Perez Garcia
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902808314
PECOS PAC ID: 3375519226
Enrollment ID: I20131107001355
Provider NameWilliam Gonzalez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467693358
PECOS PAC ID: 4789810771
Enrollment ID: I20131121001467
Provider NameYvonne M Tyson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013353143
PECOS PAC ID: 8224260286
Enrollment ID: I20140407001262
Provider NameJane Diamond
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689806044
PECOS PAC ID: 6406996479
Enrollment ID: I20140417001897
Provider NameVictoria Udongwo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962820738
PECOS PAC ID: 2769606177
Enrollment ID: I20140604002091
Provider NameHeather Ledford
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811367618
PECOS PAC ID: 1951601236
Enrollment ID: I20151119000161
Provider NameDavid Brian Remias
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316258759
PECOS PAC ID: 0143547711
Enrollment ID: I20160122001073
Provider NameMichael Peterson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1184037020
PECOS PAC ID: 9537467329
Enrollment ID: I20160412000272
Provider NameArnold V Feliciano
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386018075
PECOS PAC ID: 5890086490
Enrollment ID: I20160628002072
Provider NameTimothy J Flynn
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1205850765
PECOS PAC ID: 7810068343
Enrollment ID: I20170526002060
Provider NameNatalie J Hollis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356877625
PECOS PAC ID: 9537431556
Enrollment ID: I20170824003082
Provider NameBradley Taylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508388240
PECOS PAC ID: 7416221353
Enrollment ID: I20170915003027
Provider NameEdward Orshansky
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1285054460
PECOS PAC ID: 8820218548
Enrollment ID: I20171120003394
Provider NameSarah Curtis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215461512
PECOS PAC ID: 2668739665
Enrollment ID: I20171129002355
Provider NameRosemary T Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306392949
PECOS PAC ID: 9234427287
Enrollment ID: I20180718004017
Provider NameJaime Maurer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932618485
PECOS PAC ID: 2264789312
Enrollment ID: I20180719002378
Provider NameTroy F Borema
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1144217308
PECOS PAC ID: 9739328634
Enrollment ID: I20180827003061
Provider NameVicki Teal
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518457357
PECOS PAC ID: 4284984865
Enrollment ID: I20180830003692
Provider NameBrittany Martens
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710472519
PECOS PAC ID: 2860743580
Enrollment ID: I20180919002835
Provider NameChrista W Lehman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124534268
PECOS PAC ID: 6800147406
Enrollment ID: I20180920002006
Provider NameRyan Hillman Reynolds
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245718295
PECOS PAC ID: 2860744638
Enrollment ID: I20181004002501
Provider NameHarry T Madhanagopal
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1740568278
PECOS PAC ID: 5890928899
Enrollment ID: I20181019002151
Provider NameAlexandra Damirkasan Rivera
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033761523
PECOS PAC ID: 6709212558
Enrollment ID: I20200214001001
Provider NameNichole Atkins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528611563
PECOS PAC ID: 4183052319
Enrollment ID: I20200329000090
Provider NameKristina Rijo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093339467
PECOS PAC ID: 0345666525
Enrollment ID: I20200818004017
Provider NameBrittany Cabler
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366039208
PECOS PAC ID: 8022423227
Enrollment ID: I20210222001433
Provider NameCatherine Abigail Schaffer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851025993
PECOS PAC ID: 1153704655
Enrollment ID: I20220816003000
Provider NameAngela Michelle Najafi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811627102
PECOS PAC ID: 1456735711
Enrollment ID: I20220906000918
Provider NameCandice Negrete
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700127313
PECOS PAC ID: 1153553656
Enrollment ID: I20220926002795
Provider NameRobert Edward Stapleton
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1295154623
PECOS PAC ID: 9335515360
Enrollment ID: I20221017002393
Provider NameShaunna Marie Stetzer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497477525
PECOS PAC ID: 6406223734
Enrollment ID: I20221031000435
Provider NameJames Walker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1952094856
PECOS PAC ID: 4486015153
Enrollment ID: I20230727001141
Provider NameDavis Brent Hart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447951199
PECOS PAC ID: 3476915901
Enrollment ID: I20230816001500
Provider NameKeegan Hickey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750165627
PECOS PAC ID: 6507212602
Enrollment ID: I20231026000058
Provider NameAnna Marie Tran
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1528492899
PECOS PAC ID: 2961805155
Enrollment ID: I20240531002360
Provider NameMaranda Nicole Massey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346426764
PECOS PAC ID: 3678015260
Enrollment ID: I20240611002266
Provider NameJessica Bradshaw
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558104919
PECOS PAC ID: 0244776714
Enrollment ID: I20240719002371

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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.