Jason R Thompson (NPI# 1306916580, PAC ID# 3476513201) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1306916580 |
| PAC ID by PECOS | 3476513201 |
| Professional Enrollment ID | I20041018001120 |
| Full Name | Jason R Thompson |
| Organization Legal Name | FWC UROGYNECOLOGY LLC |
| Address |
84 Pinnacles Dr Suite 500 Palm Coast FL 32164-2324 |
| Phone Number | 9046520373 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 1992 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 8022276542 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100307 | ST VINCENT'S MEDICAL CENTER SOUTHSIDE |
| 100040 | ST VINCENT'S MEDICAL CENTER RIVERSIDE |
| 100088 | BAPTIST MEDICAL CENTER JACKSONVILLE |
| 100179 | MEMORIAL HOSPITAL JACKSONVILLE |
| 100117 | BAPTIST MEDICAL CENTER BEACHES |
| Address | Phone | Organization |
|---|---|---|
| 84 Pinnacles Dr, Suite 500, Palm Coast, FL 32164-2324 | 9046520373 | FWC UROGYNECOLOGY LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 84% | |
| MIPS_EC_050_overall | Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older | 64% |
| Organization Legal Name | FWC UROGYNECOLOGY LLC |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie D Short | Certified Nurse Midwife (cnm) | Fwc Urogynecology LLC | 2801 Se 1st Ave, Suite 101, Ocala, FL 34471-0478 |
| Samuel Del Rio | Obstetrics/gynecology | Fwc Urogynecology LLC | 8043 Spyglass Hill Rd, Suite 101, Melbourne, FL 32940-8563 |
| Gregory J Bailey | Obstetrics/gynecology | Fwc Urogynecology LLC | 6440 W Newberry Rd, Suite 409, Gainesville, FL 32605-4381 |
| Meghan L Mader | Nurse Practitioner | Fwc Urogynecology LLC | 2801 Se 1st Ave, Suite 101, Ocala, FL 34471-0478 |
| Lindsay S Mason | Nurse Practitioner | Fwc Urogynecology LLC | 5323 4th Ave Circle E, Bradenton, FL 34208-5623 |
| Lynn Marie Millard | Nurse Practitioner | Fwc Urogynecology LLC | 2801 Se 1st Ave, Suite 101, Ocala, FL 34471-0478 |
| Rafael J Perez | Obstetrics/gynecology | Fwc Urogynecology LLC | 7000 Sw 62nd Ave, Miami, FL 33143-4716 |
| Kathy Y Jones | Obstetrics/gynecology | Fwc Urogynecology LLC | 2501 N Orange Ave, Suite 309, Orlando, FL 32804-4642 |
| Brittnie E Sanders | Nurse Practitioner | Fwc Urogynecology LLC | 2801 Se 1st Ave, Suite 101, Ocala, FL 34471-0478 |
| Maria De La Luz L Nieto | Obstetrics/gynecology | Fwc Urogynecology LLC | 1309 N Flagler Dr, Good Samaritan Medical Center, West Palm Beach, FL 33401-3406 |
| Street Address |
84 PINNACLES DR SUITE 500 |
| City | PALM COAST |
| State | FL |
| Zip | 32164-2324 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Don Joseph Alfonso | Family Medicine | Ardent Family Care Pa | 84 Pinnacles Dr, Suite 200, Palm Coast, FL 32164-2324 |
| Mirian G Langer | Nurse Practitioner | Ardent Family Care Pa | 84 Pinnacles Dr, Suite 200, Palm Coast, FL 32164-2324 |
| Renato A Alfonso | Internal Medicine | Ardent Family Care Pa | 84 Pinnacles Dr, Suite 200, Palm Coast, FL 32164-2324 |
| Mary K Reynolds | Nurse Practitioner | Ardent Family Care Pa | 84 Pinnacles Dr, Suite 200, Palm Coast, FL 32164-2324 |
| Kenneth M Roberts | Physician Assistant | Florida Urology Center Pa | 84 Pinnacles Dr, Suite 500, Palm Coast, FL 32164-2324 |
| Ross C Wheeler | Dermatology | 84 Pinnacles Dr, Suite 400, Palm Coast, FL 32164-2324 | |
| Robert Bruce Perri | Nurse Practitioner | Ardent Family Care Pa | 84 Pinnacles Dr, Suite 200, Palm Coast, FL 32164-2324 |
| Vicki S Ma | Occupational Therapy | Physical Therapy Professionals and Associates, Inc. | 84 Pinnacles Dr, Suite 300, Palm Coast, FL 32164-2324 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank Michael Alea | Vascular Surgery | Roy H Hinman Md Pa | 2 Mccormick Dr, Palm Coast, FL 32164-2352 |
| Peter Richard Accorti | Nurse Practitioner | Estate Ventures LLC | 57 Town Ct, Suite 123, Palm Coast, FL 32164-2425 |
| Kai Mcgreevy | Neurology | Estate Ventures LLC | 57 Town Ct, Suite 123, Palm Coast, FL 32164-2425 |
| Joseph Mckinley | Gastroenterology | Memorial Hospital Flagler Inc | 21 Hospital Dr, Suite 110, Palm Coast, FL 32164-2453 |
| Emily Jeanne Havener Billstein | Physician Assistant | Memorial Hospital Flagler Inc | 21 Hospital Dr, Suite 110, Palm Coast, FL 32164-2453 |
| Ebony M Benjamin | Certified Registered Nurse Anesthetist (crna) | Sheridan Healthcorp Inc | 21 Hospital Dr, Suite 220, Palm Coast, FL 32164-2453 |
| David Gay | Orthopedic Surgery | Memorial Hospital Flagler Inc | 21 Hospital Dr, Suite 110, Palm Coast, FL 32164-2453 |
| Wallace M Combs Ii | Gastroenterology | Memorial Hospital Flagler Inc | 21 Hospital Dr, Suite 110, Palm Coast, FL 32164-2453 |
| Izabela M Wasiluk | Anesthesiology | Sheridan Healthcorp Inc | 21 Hospital Dr, Suite 220, Palm Coast, FL 32164-2453 |
| Dennis Alter | Orthopedic Surgery | Memorial Hospital Flagler Inc | 21 Hospital Dr, Suite 110, Palm Coast, FL 32164-2453 |
| Find all physicians in zip 32164 | |||
| City | PALM COAST |
| Zip Code | 32164 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | PALM COAST + OBSTETRICS/GYNECOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.