Jonathan Divine, DO - Medicare Family Practice in Jacksonville, FL

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Jonathan Divine, DO is a medicare enrolled "Family Medicine" physician in Jacksonville, Florida. He went to West Virginia School Of Osteopathic Medicine and graduated in 2007 and has 18 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice St Vincent's Ambulatory Care Inc, Lake Area Physical Therapy Inc. and his current practice location is 3059 Edgewood Ave W, Jacksonville, Florida. You can reach out to his office (for appointments etc.) via phone at (904) 647-3180.

Jonathan Divine is licensed to practice in Florida (license number OS 10858) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1710173968.

Contact Information

Jonathan Divine, DO
3059 Edgewood Ave W,
Jacksonville, FL 32209-2207
(904) 647-3180
Not Available

Map and Direction




Physician's Profile

Full NameJonathan Divine
GenderMale
SpecialityFamily Practice
Experience18 Years
Location3059 Edgewood Ave W, Jacksonville, Florida
Accepts Medicare AssignmentsMay be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jonathan Divine attended and graduated from West Virginia School Of Osteopathic Medicine in 2007
  NPI Data:
  • NPI Number: 1710173968
  • Provider Enumeration Date: 09/21/2007
  • Last Update Date: 10/08/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 9133311368
  • Enrollment ID: I20101006001053

Medical Identifiers

Medical identifiers for Jonathan Divine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710173968NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine OS 10858 (Florida)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Baptist Home Health CareJacksonville, FLHome health agency
Ascension St Vincent's Clay CountyMiddleburg, FLHospital
Ascension St Vincent's RiversideJacksonville, FLHospital
Ed Fraser Memorial HospitalMacclenny, FLHospital
Baptist Health Medical Center - JacksonvilleJacksonville, FLHospital
Ascension St Vincent's SouthsideJacksonville, FLHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
St Vincent's Ambulatory Care Inc2860411188255
Lake Area Physical Therapy Inc.3678604840252

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jonathan Divine allows following entities to bill medicare on his behalf.
Entity NameSt Vincent's Ambulatory Care Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417987124
PECOS PAC ID: 2860411188
Enrollment ID: O20051116000430

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonathan Divine is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jonathan Divine, DO
3059 Edgewood Ave W,
Jacksonville, FL 32209-2207

Ph: (904) 647-3180		Jonathan Divine, DO
3059 Edgewood Ave W,
Jacksonville, FL 32209-2207

Ph: (904) 647-3180

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.