JERRY TAVORNWATTANA
NPI 1093177982
Emergency Medicine in Jacksonville, FL

Active since March 22, 2016PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
655 W 8TH ST # C506, JACKSONVILLE, FL 32209(904) 244-3817 Get Directions Write a Review

NPPES record last updated: June 5, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 5, 2019, Mar 22, 2016 (2 updates tracked since 2016).

About Jerry Tavornwattana NPPES

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

JERRY TAVORNWATTANA (NPI 1093177982) is an individual emergency medicine provider in Jacksonville, Florida, licensed in Florida (ME140761) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and is a graduate of Wayne State University School Of Medicine (2016).

NPPES Registry Identity

NPI1093177982
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameJERRY TAVORNWATTANA
Location Address655 W 8TH ST # C506Jacksonville, FL 32209-6511
Mailing Address655 W 8th St # C506Jacksonville, FL 32209-6511
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2016
Enumeration DateMarch 22, 2016
Last NPPES UpdateJune 5, 20192 updates tracked since enumeration
NPI 1093177982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in FL · ME140761
Definition

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.

655 W 8TH ST # C506, Jacksonville, FL 32209

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

Jerry Tavornwattana 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 ID2264726207
PECOS Enrollment IDI20190816000322
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 4

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.

Emergency department visit with high level of medical decision making 99285
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.
473 services459 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
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.
334 services308 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
113 services111 patients
Emergency department visit with moderate level of medical decision making 99284
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.
61 services61 patients

Hospital Affiliations CMS Care Compare

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

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32209 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Other Providers at the Same Location NPPES 20

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

Emergency Medicine
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR
JACKSONVILLE, FL 32209
Emergency Medicine
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR
JACKSONVILLE, FL 32209
Emergency Medicine
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR
JACKSONVILLE, FL 32209
Emergency Medicine
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR
JACKSONVILLE, FL 32209
Emergency Medicine
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR
JACKSONVILLE, FL 32209
Emergency Medicine
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR
JACKSONVILLE, FL 32209
Emergency Medicine
655 W 8TH ST # C506
JACKSONVILLE, FL 32209
Emergency Medicine
655 W 8TH ST # C506
JACKSONVILLE, FL 32209

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1093177982, enumerated as an "individual" on March 22, 2016.

The provider is located at 655 W 8TH ST # C506 JACKSONVILLE, FL 32209 and the phone number is (904) 244-3817.

Emergency Medicine with taxonomy code 207P00000X.

Jerry Tavornwattana is affiliated with: ADVENTHEALTH ORLANDO.