DR. GRADY AUSBUR FORTNER M.D.
NPI 1043636202
Emergency Medicine in Jacksonville, FL

NPI Status: Active since March 12, 2014

Contact Information

554 KEILY STREET
JACKSONVILLE, FL
ZIP 32212
Phone: (757) 953-7550
Fax: (757) 953-7560

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  • Individual
  • Male
  • Emergency Medicine
  • Accepts Insurance
  • PECOS Enrolled

About GRADY FORTNER

This page provides the complete NPI Profile along with additional information for Grady Fortner, a provider established in Jacksonville, Florida with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1043636202 assigned on March 2014. The practitioner's primary taxonomy code is 207P00000X with license number M-2191 (GU). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1043636202
Provider Name
DR. GRADY AUSBUR FORTNER M.D.
Gender
Male
Entity Type
Individual
Location Address
554 KEILY STREET JACKSONVILLE, FL 32212
Location Phone
(757) 953-7550
Location Fax
(757) 953-7560
Mailing Address
PO BOX 25578 BARRIGADA, GU 96921
Mailing Phone
(671) 480-7934
Is Sole Proprietor?
Yes
Enumeration Date
03-12-2014
Last Update Date
12-17-2019
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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

Emergency Medicine

Taxonomy Code
207P00000X
Type
Allopathic & Osteopathic Physicians
License No.
M-2191
License State
GU
Taxonomy Description
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207P00000XAllopathic & Osteopathic Physicians

Emergency Medicine

0116027243 (VA)

Insurance Plans Accepted

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

  • Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
  • Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
  • Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
  • Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
  • Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS
  • Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (BR) - POS
  • Precision Blue 80/60 $3200 with 2 $0 PCP Virtual Visits (M) - POS
  • Precision Blue 90/70 $9900 with 2 $0 PCP Virtual Visits (M) HSA Eligible - POS
  • Precision Blue Copay (PCP) 50/50 $7500 Standardized (BR) HSA Eligible - POS
  • Precision Blue Copay (PCP) 50/50 $7500 Standardized (M) HSA Eligible - POS
  • Precision Blue Copay (PCP) 60/40 $6000 Standardized (BR) - POS
  • Precision Blue Copay (PCP) 60/40 $6000 Standardized (M) - POS
  • Precision Blue Copay (PCP) 75/55 $2000 Standardized (BR) - POS
  • Precision Blue Copay (PCP) 75/55 $2000 Standardized (M) - POS
  • Signature Blue 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
  • Signature Blue 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
  • Signature Blue Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
  • Signature Blue Copay (PCP) 60/40 $6000 Standardized - POS

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

Medicare Participation & PECOS Enrollment Status

Grady Fortner 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

  • 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.

Emergency department visit for life threatening or functioning severity

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

This service was performed 63 times for 62 patients

Emergency department visit for problem of high severity

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

This service was performed 21 times for 21 patients

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

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 21 times for 21 patients

Physician Visit Costs

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 32212 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $87.62
  • Minimum New Patient Price $56
  • Maximum New Patient Price $171.84
  • Average New Patient Copayment $21.9
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.96

Established Patients Visit Costs *

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

  • Average Established Patient Price $99.16
  • Minimum Established Patient Price $17.57
  • Maximum Established Patient Price $139.16
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $34.79

* 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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043636202, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
2
Unchanged
Pos 9
0
Doubled → 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 6 → 12 → 3 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 1 + 2 + 3 + 1 + 2 + 2 + 0 + 24 = 48

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1043636202.

Other Providers at the Same Location


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

Dentist
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY CCPD
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUMED, CENTRALIZED CRED & PRIV DIRECTORATE
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY-CENTRALIZED CREDENTIALS
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MED AND SURGERY CREDENTIALS
JACKSONVILLE, FL 32212
Dental Hygienist
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY CCPD
JACKSONVILLE, FL 32212
Dental Hygienist
554 KEILY STREET, BUREAU OF MEDICINE AND SURG CENTRALIZED CRED AND PRIV
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY -CENTRALIZED CREDENTIALS
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MEDICINE & SURG CENT CREDENTIALS & PRIVILEGIN
JACKSONVILLE, FL 32212
Pediatrics
554 KEILY STREET
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MED AND SURG - CCPD
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MED AND SURG CCPD
JACKSONVILLE, FL 32212
Dental Hygienist
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY-CREDENTIALS
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MED AND SURGERY -CREDENTIALING
JACKSONVILLE, FL 32212
Dental Hygienist
554 KEILY STREET, BUREAU OF MEDICINE & SURGERY - CREDENTIALS AND PRIVILEG
JACKSONVILLE, FL 32212
Emergency Medicine
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY CCPD
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MED AND SURG CREDENTIALING AND PRIVILEGEING
JACKSONVILLE, FL 32212
Dentist
554 KEILY STREET, BUREAU OF MEDICINE AND SURG CENTRALIZED CREDENTIALS
JACKSONVILLE, FL 32212
Pediatrics (Pediatric Hematology-Oncology)
554 KEILY STREET
JACKSONVILLE, FL 32212
Dental Hygienist
554 KEILY STREET, CCPD BUREAU OF MED AND SURGERY
JACKSONVILLE, FL 32212

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043636202, enumerated as an "individual" on March 12, 2014.

The provider is located at 554 KEILY STREET JACKSONVILLE, FL 32212 and the phone number is (757) 953-7550.

Emergency Medicine with taxonomy code 207P00000X.

The provider might be accepting Accepts: HMO Louisiana. Please consult your insurance carrier or call the provider to verify.