JACK IRVIN NEWCOMER MD
NPI 1750498259
Family Medicine - Sports Medicine in Wellington, FL

NPI Status: Active since August 23, 2006

Contact Information

3319 STATE ROAD 7
STE 108
WELLINGTON, FL
ZIP 33449
Phone: (561) 798-2800
Fax: (561) 793-6631

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  • Individual
  • Male
  • Years of Experience 45
  • Family Medicine
  • Sports Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting
  • CLIA Number: 10D2038009
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-11-2026

About JACK NEWCOMER

This page provides the complete NPI Profile along with additional information for Jack Newcomer, a primary care provider established in Wellington, Florida with a medical specialization in Family Medicine, focusing in sports medicine and more than 45 years of experience. The healthcare provider is registered in the NPI registry with number 1750498259 assigned on August 2006. The practitioner's primary taxonomy code is 207QS0010X with license number ME0048252 (FL). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1750498259
Provider Name
JACK IRVIN NEWCOMER MD
Gender
Male
Entity Type
Individual
Location Address
3319 STATE ROAD 7 STE 108 WELLINGTON, FL 33449
Location Phone
(561) 798-2800
Location Fax
(561) 793-6631
Mailing Address
3319 STATE ROAD 7 108 WELLINGTON, FL 33449
Mailing Phone
(561) 798-2800
Mailing Fax
(561) 793-6631
Medical School Name
OTHER
Graduation Year
1981
Is Sole Proprietor?
No
Enumeration Date
08-23-2006
Last Update Date
03-03-2016
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A primary care provider (PCP) like Jack Newcomer sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Sports Medicine

Taxonomy Code
207QS0010X
Type
Allopathic & Osteopathic Physicians
License No.
ME0048252
License State
FL
Taxonomy Description
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Connect Bronze 0 Indiv Med Deductible - EPO
  • Connect Bronze 5500 Indiv Med Deductible - EPO
  • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Bronze CMS Standard - EPO
  • Connect Gold 2000 Indiv Med Deductible - EPO
  • Connect Gold 800 Indiv Med Deductible - EPO
  • Connect Gold CMS Standard - EPO
  • Connect Silver 3600 Indiv Med Deductible - EPO
  • Connect Silver 4300 Indiv Med Deductible - EPO
  • Connect Silver CMS Standard - EPO
  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
  • BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Gold Classic Standard - EPO
  • Gold Elite - EPO
  • Gold Elite Saver Plus - EPO
  • Secure - EPO
  • Silver Classic Standard - EPO
  • Silver Elite - EPO
  • Silver Simple Chronic Care CKM - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Value ($0 Virtual Urgent Care) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
  • UHC Gold Standard - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Silver Standard - HMO
  • UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
D57261MEDICARE UPIN (02)FL 
61505YMEDICARE PIN (08)FL 

Medicare Participation & PECOS Enrollment Status

Jack Newcomer is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jack Newcomer is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6901863075

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20041210000497

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Annual depression screening, 15 minutes

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

This service was performed 171 times for 171 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 174 times for 174 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

This service was performed 20 times for 20 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 123 times for 92 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 456 times for 180 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 41 times for 33 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 17 times for 11 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 19 times for 18 patients

Transitional care management services for problem of high complexity

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

This service was performed 12 times for 12 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.92 for a new patient copayment and $25.8 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 33449 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $91.69
  • Minimum New Patient Price $58.56
  • Maximum New Patient Price $179.05
  • Average New Patient Copayment $22.92
  • Minimum New Patient Copayment $14.64
  • Maximum New Patient Copayment $44.76

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $103.21
  • Minimum Established Patient Price $18.44
  • Maximum Established Patient Price $144.68
  • Average Established Patient Copayment $25.8
  • Minimum Established Patient Copayment $4.61
  • Maximum Established Patient Copayment $36.17

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 100% 199
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jack Newcomer is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HCA FLORIDA PALMS WEST HOSPITAL13001 SOUTHERN BLVD
LOXAHATCHEE, FL 33470
(561) 798-3300Acute Care Hospitals
WELLINGTON REGIONAL MEDICAL CENTER10101 FOREST HILL BLVD
WELLINGTON, FL 33414
(561) 798-8500Acute Care Hospitals

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2038009
Facility Type
Physician Office
Certificate Effective Date
March 12, 2024
Certificate Expiration Date
March 11, 2026
Laboratory Director
DR. JACK I. NEWCOMER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Jack Newcomer to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750498259
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271008916210
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 8 + 9 + 1 + 6 + 2 + 1 + 0 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1750498259 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1922085364WOMEN'S BREAST CARE CENTER, INC
Organization
Specialist3319 STATE ROAD 7 SUITE 105
WELLINGTON, FL 33449
(561) 965-1100
1699733972DR. JOSE L MARTINEZ MD PA MD
Individual
Internal Medicine3319 STATE ROAD 7 STE 215
WELLINGTON, FL 33449
(561) 791-1630
1083624894DR. TOMER HAIK DDS
Individual
Dentist (Pediatric Dentistry)3319 STATE ROAD 7 SUITE 312
WELLINGTON, FL 33449
(561) 333-8441
1609918671 LAWRENCE STRONG
Individual
Dermatology (Procedural Dermatology)3319 STATE ROAD 7 SUITE 110
WELLINGTON, FL 33449
(561) 784-7884
1285763441GUIDING LIGHT WELLNESS CENTER LLC
Organization
Psychiatry & Neurology (Psychiatry)3319 STATE ROAD 7 SUITE 210
WELLINGTON, FL 33449
(561) 422-3314
1649485608DERMATOLOGY CENTER OF WELLINGTON PA
Organization
Dermatology3319 STATE ROAD 7 SUITE 110
WELLINGTON, FL 33449
(561) 784-7884
1013104645ANITA GARIB-SANKAR, MD PA
Organization
Preferred Provider Organization3319 STATE ROAD 7 STE 113
WELLINGTON, FL 33449
(561) 422-1003
1922252121WELLINGTON MEDSTAT LLC
Organization
Clinic/Center (Urgent Care)3319 STATE ROAD 7 SUITE 102
WELLINGTON, FL 33449
(561) 333-4000
1871748665JOSE L MARTINEZ MD PA
Organization
Internal Medicine3319 STATE ROAD 7 SUITE 215
WELLINGTON, FL 33449
(561) 791-1630
1972818557SURGICAL ARTS PAVILION LLC
Organization
Clinic/Center (Ambulatory Surgical)3319 STATE ROAD 7 STE 105
WELLINGTON, FL 33449
(561) 965-1100
1336407527TRUDERM PA
Organization
Dermatology (Pediatric Dermatology)3319 STATE ROAD 7 SUITE 202
WELLINGTON, FL 33449
(561) 207-8080
1104067222GENERAL SURGERY OF PALM BEACH, LLC
Organization
Surgery3319 STATE ROAD 7 SUITE 207
WELLINGTON, FL 33449
(561) 753-1101
1144216664 ROBERT NISENBAUM DO
Individual
Emergency Medicine3319 STATE ROAD 7 102
WELLINGTON, FL 33449
(561) 333-4000
1922062272 CORRAINE ELIZABETH YOUNG-HELMS M.D.
Individual
Anesthesiology3319 STATE ROAD 7 SUITE 207
WELLINGTON, FL 33449
(561) 753-1101
1942641667PALM BEACH MEDICINE LLC
Organization
Internal Medicine (Gastroenterology)3319 STATE ROAD 7 SUITE 207
WELLINGTON, FL 33449
(561) 753-1101
1669602942 CLAUDIA MARIA GIOVANELLI PORRATA MD, MPH
Individual
Preventive Medicine (Public Health & General Preventive Medicine)3319 STATE ROAD 7 SUITE # 212
WELLINGTON, FL 33449
(561) 318-3727
1871743062JACK I NEWCOMER MD PA
Organization
Family Medicine (Sports Medicine)3319 STATE ROAD 7 SUITE 108
WELLINGTON, FL 33449
(561) 798-2800
1790728913DR. BRETT ALAN SCHLIFKA D.O.
Individual
Neurological Surgery3319 STATE ROAD 7 SUITE 313
WELLINGTON, FL 33449
(561) 433-4444
1093164790 DAVID ALEXANDER KER MCALPINE DPT
Individual
Physical Therapist3319 STATE ROAD 7
WELLINGTON, FL 33449
(561) 795-5870
1528199411 YVETTE LACLAUSTRA M.D.
Individual
Surgery3319 STATE ROAD 7 SUITE 105
WELLINGTON, FL 33449
(561) 965-1100

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750498259, enumerated in the NPI registry as an "individual" on August 23, 2006

The provider is located at 3319 State Road 7 Ste 108 Wellington, Fl 33449 and the phone number is (561) 798-2800

The provider's speciality is Family Medicine with taxonomy code 207QS0010X with a focus in Sports Medicine

The provider has more than 45 years of experience.

The provider might be accepting Accepts: Aetna CVS Health, Cigna Healthcare, Florida Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $91.69 with an average copayment of $22.92 for new patient appointments. Established patients should expect a typical charge of $103.21 and an average copayment of 25.8. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Annual depression screening, 15 minutes, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Hemoglobin a1c level, Melanoma (skin cancer) excision, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report and Transitional care management services for problem of high complexity.

The provider's CLIA number is 10D2038009 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

The practitioner is affiliated to the following hospital(s): HCA FLORIDA PALMS WEST HOSPITAL and WELLINGTON REGIONAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on August 23, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.