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CRAIG B MORGENTHAL MD
NPI 1114961554
Surgery in Jacksonville, FL

Active since June 16, 2006PECOS EnrolledAccepts Medicare Assignment
79.26/100
CMS Quality Rating
836 PRUDENTIAL DR, SUITE 1001, JACKSONVILLE, FL 32207(904) 398-0033(904) 398-6774 Get Directions Write a Review

NPPES record last updated: July 28, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Craig B Morgenthal Md NPPES

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

CRAIG B MORGENTHAL MD (NPI 1114961554) is an individual surgery provider in Jacksonville, Florida, licensed in Florida (ME97599) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1114961554
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameCRAIG B MORGENTHALCredential: MD
Location Address836 PRUDENTIAL DR, SUITE 1001Jacksonville, FL 32207-8334
Mailing Address11945 San Jose Blvd, Bldg 300Jacksonville, FL 32223-1627 · (904) 396-1725 · Fax (904) 399-1717
Phone(904) 398-0033
Fax(904) 398-6774
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateJune 16, 2006
Last NPPES UpdateJuly 28, 2015
✔ NPI 1114961554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in FL · ME97599
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

836 PRUDENTIAL DR, Jacksonville, FL 32207
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Other Identifiers 8

Other7657775FL · Aetna
Medicaid277839400FL
Medicare PINAG867ZFL
Other306906FL · Avmed
Other5850547FL · Cigna
Other93691FL · Blue Cross Blue Shield
OtherP00440983Railroad Medicare
Medicare UPIN154687FL

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

Craig B Morgenthal 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 ID8123031564
PECOS Enrollment IDI20071207000035
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 7

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
73 services73 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.
63 services54 patients
Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope 43282
This procedure fixes a hernia, a bulge or tear, in the muscle where the esophagus meets the stomach. Using an endoscope, a thin tube with a camera, a mesh is implanted to strengthen the area and prevent future hernias.
32 services32 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.
23 services23 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
19 services19 patients
Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

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

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100117
Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County
Emergency services Birthing friendly

Baptist Medical Center - Nassau

Acute Care Hospitals · Fernandina Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100140
Location1250 S 18th StFernandina Beach, FL 32034 · Nassau County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32207 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
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
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.

79.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.47
Promoting Interoperability96
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
6%194 patients1/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
25%182 patients2/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
68%69 patients3/55-star benchmark: 99%
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.
97%1,128 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
92%165 patients3/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
86%466 patients4/55-star benchmark: 88%
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.
100%329 patients5/55-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.
67%953 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
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…
67%669 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 95% · 477 patients
91%204 patients4/55-star benchmark: 98%
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…
100%953 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
9%953 patients1/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 1% · 161 patients
1%169 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
45%953 patients
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 5

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

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
3 suppliers14 claims226 services$2.50 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
4 suppliers19 claims510 services$5.76 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
4 suppliers19 claims510 services$3.32 avg. paid by Medicare
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce A4455
DME-Medical/Surgical Supplies · category DA000N
3 suppliers13 claims20 services$1.17 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
4 suppliers13 claims475 services$0.23 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 20

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

REPRODUCTIVE MEDICINE ASSOCIATES, P.A.
Obstetrics & Gynecology (Reproductive Endocrinology)
836 PRUDENTIAL DR, SUITE 902
JACKSONVILLE, FL 32207
Duval County (904) 399-5620
HECTOR EDWARD JAMES MD
Neurological Surgery
836 PRUDENTIAL DR, UFJP NEUROSURGERY - PEDIATRICS
JACKSONVILLE, FL 32207
Duval County (904) 398-5201
DR. ALAN RONALD ECKELS M.D.
Specialist
836 PRUDENTIAL DR, SUITE 1606
JACKSONVILLE, FL 32207
Duval County (904) 396-3700
ERIN M MOORE MD
Surgery (Vascular Surgery)
836 PRUDENTIAL DR, STE 1804
JACKSONVILLE, FL 32207
Duval County (904) 398-3888
HAYDEN POTTER APRN
Nurse Practitioner (Family)
836 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 000-0000
JOSEPH DAVID ALLEN PA-C
Physician Assistant (Medical)
836 PRUDENTIAL DR, SUITE 801
JACKSONVILLE, FL 32207
Duval County (904) 288-0433
JEFFREY D RICKETTS PA
Physician Assistant (Surgical)
836 PRUDENTIAL DR, STE 1804
JACKSONVILLE, FL 32207
Duval County (904) 398-3888
ALEXANDER TUAN ROSE M.D.
Surgery
836 PRUDENTIAL DR, SUITE 1001
JACKSONVILLE, FL 32207
Duval County (904) 398-0033

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 Craig Morgenthal's NPI number?

The NPI number for Craig Morgenthal is 1114961554. It was assigned to this individual provider in the NPPES registry on June 16, 2006.

Where is Craig Morgenthal located?

Craig Morgenthal practices at 836 Prudential Dr Suite 1001, Jacksonville, FL 32207. The listed phone number is (904) 398-0033.

What is Craig Morgenthal's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Craig Morgenthal enrolled in Medicare?

Yes. Craig Morgenthal 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 Craig Morgenthal accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Craig Morgenthal 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 Craig Morgenthal affiliated with any hospitals?

According to CMS data, Craig Morgenthal is affiliated with Baptist Health Medical Center - Jacksonville, Baptist Medical Center Beaches and Baptist Medical Center - Nassau.

When was this NPI record last updated?

The NPPES record for Craig Morgenthal was last updated on July 28, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.