- Medicare Primary Care in Jacksonville, FL

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is a medicare enrolled primary clinic (Family Medicine) in Jacksonville, Florida. The current practice location for is 9857 Old Saint Augustine Rd Ste 1, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 861-1900. The mailing address for is 9857 Old Saint Augustine Rd Ste 1, Jacksonville, Florida and phone number is (904) 861-1900.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1053366880. 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) 861-1900.

Contact Information

9857 Old Saint Augustine Rd Ste 1
Jacksonville
FL 32257-8821
(904) 861-1900
(904) 292-9684

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityFamily Medicine
Location9857 Old Saint Augustine Rd Ste 1, Jacksonville, Florida
Authorized Official Name and PositionDavid Romanello (COO)
Authorized Official Contact3524593661
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

9857 Old Saint Augustine Rd Ste 1
Jacksonville
FL 32257-8821

Ph: (904) 861-1900
9857 Old Saint Augustine Rd Ste 1
Jacksonville
FL 32257-8821

Ph: (904) 861-1900

NPI Details:

NPI Number1053366880
Provider Enumeration Date05/23/2006
Last Update Date09/20/2024

Medicare PECOS Information:

Medicare PECOS PAC ID9133020787
Medicare Enrollment IDO20040116000189

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053366880NPI-NPPES
1018488OtherOTHER ID NUMBER-COMMERCIAL NUMBER
39739OtherFLBLUE CROSS BLUE SHIELD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary
208000000XPediatrics (* (Not Available))Secondary

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 NameLaura J Zalcberg
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1730256512
PECOS PAC ID: 3375566995
Enrollment ID: I20060111000322
Provider NameErnesto L Izquierdo
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1629182662
PECOS PAC ID: 0547260127
Enrollment ID: I20070104000288
Provider NameJesus M Logronio
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1437244571
PECOS PAC ID: 0345242244
Enrollment ID: I20070206000366
Provider NameJean M Ehrhardt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720264294
PECOS PAC ID: 0244309979
Enrollment ID: I20080520000779
Provider NameAllen Okie
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1255394896
PECOS PAC ID: 7214052323
Enrollment ID: I20100913001102
Provider NameMajed Boulos Hassan
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1366599540
PECOS PAC ID: 5698676252
Enrollment ID: I20130214000192
Provider NameGrace Merchant
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780737197
PECOS PAC ID: 8325091135
Enrollment ID: I20130423000333
Provider NameEdu Anthony Kirindongo
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629030747
PECOS PAC ID: 1355358516
Enrollment ID: I20130430000146
Provider NameSam N Benson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265859516
PECOS PAC ID: 5193943884
Enrollment ID: I20140821000720
Provider NameMusaddeque Ahmad
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1093738742
PECOS PAC ID: 5092799130
Enrollment ID: I20151105002211
Provider NameMigdaliz Cotto Ayala
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1720286545
PECOS PAC ID: 4688977846
Enrollment ID: I20160121001011
Provider NamePedro Pablo Aragon Amargo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487124566
PECOS PAC ID: 6002156700
Enrollment ID: I20190315001053
Provider NameAlexa Wu-chavez
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1457334757
PECOS PAC ID: 5991718033
Enrollment ID: I20190507000085
Provider NameStanley Jose Guerrero
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396209466
PECOS PAC ID: 7810223385
Enrollment ID: I20190723001071
Provider NameJanice Aleman Pacheco
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1427020049
PECOS PAC ID: 0547200065
Enrollment ID: I20190823001641
Provider NameLourdes A Duluc-perez
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1851505572
PECOS PAC ID: 6800213083
Enrollment ID: I20200902002054
Provider NameDaniel Urdaneta
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1649587908
PECOS PAC ID: 6507148525
Enrollment ID: I20220824000538
Provider NameJorge Inocencio Pupo Guerra
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598482598
PECOS PAC ID: 0749729259
Enrollment ID: I20240828003701
Provider NameKristen Michelle Demaggio
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548019995
PECOS PAC ID: 2567902729
Enrollment ID: I20240913003253
Provider NameAmparo Judith Calderon Salom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699500892
PECOS PAC ID: 9436680147
Enrollment ID: I20241007000097

Reviews and Comments


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Phone: 904-768-8222    Fax: 904-482-0373

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.