Fountain Family Medicine, Pa - Medicare Primary Care in Jacksonville, FL

Fountain Family Medicine, Pa is a medicare enrolled primary clinic (Family Medicine) in Jacksonville, Florida. The current practice location for Fountain Family Medicine, Pa is 11701-32 San Jose Boulevard, Suite 103, Jacksonville, Florida. For appointments, you can reach them via phone at (904) 262-9075. The mailing address for Fountain Family Medicine, Pa is 11701-32 San Jose, Suite 103, Jacksonville, Florida and phone number is (904) 262-9075.

Fountain Family Medicine, Pa is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1124228119. 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) 262-9075.

Contact Information

Fountain Family Medicine, Pa
11701-32 San Jose Boulevard
Suite 103
Jacksonville
FL 32223
(904) 262-9075
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameFountain Family Medicine, Pa
SpecialityFamily Medicine
Location11701-32 San Jose Boulevard, Jacksonville, Florida
Authorized Official Name and PositionLeanne Macdonald (OFFICE MANAGER)
Authorized Official Contact9042629075
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Fountain Family Medicine, Pa
11701-32 San Jose
Suite 103
Jacksonville
FL 32223

Ph: (904) 262-9075
Fountain Family Medicine, Pa
11701-32 San Jose Boulevard
Suite 103
Jacksonville
FL 32223

Ph: (904) 262-9075

NPI Details:

NPI Number1124228119
Provider Enumeration Date07/19/2007
Last Update Date08/28/2012

Medicare PECOS Information:

Medicare PECOS PAC ID9537184114
Medicare Enrollment IDO20051012000968

Medical Identifiers

Medical identifiers for Fountain Family Medicine, Pa such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124228119NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily 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. Fountain Family Medicine, Pa acts as a billing entity for following providers:
Provider NameBoyd Daniel Evans
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790760296
PECOS PAC ID: 1254356835
Enrollment ID: I20051013000203
Provider NameRafael A Garcia
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1801068135
PECOS PAC ID: 7517155377
Enrollment ID: I20101220001139
Provider NameDana M Harrington
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134421399
PECOS PAC ID: 8224293238
Enrollment ID: I20120625000663
Provider NameKerri C Jarrell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013349604
PECOS PAC ID: 6204070774
Enrollment ID: I20130924000134

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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.