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TROY H GUTHRIE JR. MD
NPI 1073500328
Internal Medicine - Medical Oncology in Jacksonville, FL

Active since October 03, 2005PECOS EnrolledAccepts Medicare Assignment
83.26/100
CMS Quality Rating
425 N LEE ST STE 204, JACKSONVILLE, FL 32204(904) 427-1200 Get Directions Write a Review

NPPES record last updated: June 28, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 28, 2018, Feb 1, 2017, Jan 21, 2016 (3 updates tracked since 2016).

About Troy H Guthrie Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TROY H GUTHRIE JR. MD (NPI 1073500328) is an individual medical oncology provider in Jacksonville, Florida, licensed in Florida (ME66255) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Shands Jacksonville, and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1073500328
Entity TypeIndividualMale
Primary Taxonomy207RX0202X
Provider Legal NameTROY H GUTHRIE JR.Credential: MD
Location Address425 N LEE ST STE 204Jacksonville, FL 32204
Mailing Address2160 Colonial BlvdFort Myers, FL 33907-1410 · (239) 931-7342 · Fax (239) 931-7385
Phone(904) 427-1200
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1971
Enumeration DateOctober 3, 2005
Last NPPES UpdateJune 28, 20183 updates tracked since enumeration
✔ NPI 1073500328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Medical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RX0202X
License✔ Licensed in FL · ME66255
Definition
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License ME66255 (FL)
425 N LEE ST STE 204, Jacksonville, FL 32204
Open in Google Maps ↗

Secondary Practice Location 1

Location 17751 Baymeadows Rd EJacksonville, FL 32256-5836 · Phone (904) 493-5190 · Fax (904) 493-4092

Other Identifiers 10

Other1193085FL · Wellcare
OtherP01405056FL · Rr Medicare
Medicaid000643574DGA
Other12687FL · Bcbs
Other208075FL · Avmed
Other1100398FL · Careplus
Other1614130FL · Cigna
Other4402739FL · Aetna
Medicaid0533629-00FL
OtherP01756757FL · Rr Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Troy H Guthrie Jr. Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335194216
PECOS Enrollment IDI20050609000411
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
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.
236 services59 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
215 services105 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
180 services48 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
134 services20 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
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.
54 services42 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
31 services30 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Shands Jacksonville

Acute Care Hospitals · Jacksonville, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100001
Location655 W 8th StJacksonville, FL 32209 · Duval County
Emergency services Birthing friendly

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$171.84 typical visit price
range $56.00 – $171.84
Typical copayment $42.96 (range $14.00 – $42.96)
Most-billed visit code 99205
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.96
Promoting Interoperability100
Improvement Activities40
Cost63.59

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
5%41 patients1/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
4%71 patients1/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
27%368 patients1/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
48%48 patients2/55-star benchmark: 100%
Oncology: Medical and Radiation - Pain Intensity Quantified
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified
4%176 patients1/55-star benchmark: 100%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
2%368 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
10%103 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
61%66 patients3/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
11%96 patients1/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
13%103 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers13 claims728 services$0.75 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NADIA BROWN-BLACK
Nurse Practitioner (Family)
425 N LEE ST STE 204
JACKSONVILLE, FL 32204
Duval County (904) 427-1200
MOHAMMAD ASIF KHAN M.D.
Internal Medicine (Medical Oncology)
425 N LEE ST STE 204
JACKSONVILLE, FL 32204
Duval County (904) 247-1200
MR. ZHEN HOU MD
Internal Medicine (Hematology & Oncology)
425 N LEE ST STE 204
JACKSONVILLE, FL 32204
Duval County (904) 427-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Troy Guthrie's NPI number?

The NPI number for Troy Guthrie is 1073500328. It was assigned to this individual provider in the NPPES registry on October 3, 2005.

Where is Troy Guthrie located?

Troy Guthrie practices at 425 N Lee St Ste 204, Jacksonville, FL 32204. The listed phone number is (904) 427-1200.

What is Troy Guthrie's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Medical Oncology, with taxonomy code 207RX0202X.

Is Troy Guthrie enrolled in Medicare?

Yes. Troy Guthrie is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Troy Guthrie accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Troy Guthrie as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Troy Guthrie affiliated with any hospitals?

According to CMS data, Troy Guthrie is affiliated with Shands Jacksonville and Baptist Health Medical Center - Jacksonville.

When was this NPI record last updated?

The NPPES record for Troy Guthrie was last updated on June 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.