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FLAGLER FAMILY MEDICINE P A
NPI 1215080809
Family Medicine in St Augustine, FL

Active since January 19, 2007CLIA Certified · 3 labs
130 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086(904) 826-3469(904) 808-4608 Get Directions Write a Review

NPPES record last updated: July 23, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Flagler Family Medicine P A NPPES

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

FLAGLER FAMILY MEDICINE P A (NPI 1215080809) is a healthcare organization registered as a family medicine in St Augustine, Florida and active in the NPI registry since January 2007. The organization holds 3 active CLIA laboratory certificates and lists Ruth J Faircloth, Accounts Receviable Manager, as its authorized official.

NPPES Registry Identity

NPI1215080809
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFLAGLER FAMILY MEDICINE P A
Location Address130 HEALTH PARK BLVDSt Augustine, FL 32086-5776
Mailing Address130 Health Park BlvdSt Augustine, FL 32086-5776 · (904) 826-3469 · Fax (904) 808-4608
Phone(904) 826-3469
Fax(904) 808-4608
Organization SubpartNo
Authorized OfficialRuth J FairclothAccounts Receviable Manager · (904) 826-3469
Enumeration DateJanuary 19, 2007
Last NPPES UpdateJuly 23, 2008
✔ NPI 1215080809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
130 HEALTH PARK BLVD, St Augustine, FL 32086
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Other Identifiers 3

Medicare PIN21203FL
Medicaid252488100FL
OtherCD6611FL · Palmetto Gba Railroad Med

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Flagler Family Medicine P A is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

26

Medicare enrollment records show 26 clinicians reassign Medicare billing to Flagler Family Medicine P A, which bills Medicare for the services they deliver. Of these, 13 practice at this address and 17 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Family Practice11
Nurse Practitioner11
Internal Medicine3
Podiatry1

Nearest to this location (20)

See all 26
Randall Anselmo, MD
Family Practice
NPI 1417024936
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOS✔ Accepts MedicareSame address
Lindsey James, M.D.
Internal Medicine
NPI 1205026697
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOSSame address
Teri Lavenbarg, ARNP-NP
Nurse Practitioner
NPI 1932232121
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOSSame address
Lauren Lipthrott, APRN
Nurse Practitioner
NPI 1124946884
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOS✔ Accepts MedicareSame address
Katelyn Raulerson, APRN
Nurse Practitioner
NPI 1902467095
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOSSame address
Christopher Zub, D.O.
Family Practice
NPI 1972560506
130 HEALTH PARK BLVD.
St. Augustine, FL 32086
(904) 826-3469
✔ PECOS✔ Accepts MedicareSame address
Jodie Calain, D.O.
Family Practice
NPI 1912135492
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOS✔ Accepts MedicareSame address
Linda Clonch, M.D.
Family Practice
NPI 1487611166
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOS✔ Accepts MedicareSame address
Frederick Dolgin, M.D.
Family Practice
NPI 1184681876
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOSSame address
Andrew Gunn, M.D.
Family Practice
NPI 1508823295
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOSSame address
Carlos Sanchez, MD
Family Practice
NPI 1922042191
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOS✔ Accepts MedicareSame address
Warren Whitlock, M.D.
Family Practice
NPI 1538126156
130 HEALTH PARK BLVD
St Augustine, FL 32086
(904) 826-3469
✔ PECOSSame address
Daniel Donofrio, MD
Family Practice
NPI 1710090915
130 HEALTH PARK BLVD
Saint Augustine, FL 32086
(904) 826-3469
✔ PECOSSame address
Hannah Bell, ARNP
Nurse Practitioner
NPI 1427742964
100 WHETSTONE PL STE 205
Saint Augustine, FL 32086
(904) 429-9892
✔ PECOS✔ Accepts Medicare0.2 mi
Mary Schupp, ARNP
Nurse Practitioner
NPI 1851445860
100 WHETSTONE PL STE 208
St Augustine, FL 32086
(904) 447-7377
✔ PECOS0.2 mi
Myragrace Golmayo, ARNP
Nurse Practitioner
NPI 1548545361
665 STATE ROAD 207 SUITE 102
St Augustine, FL 32084
(904) 824-8158
✔ PECOS✔ Accepts Medicare1.3 mi
Suzanne Weed, DNP, ARNP
Nurse Practitioner
NPI 1497154520
32 MULBERRY STREET
Saint Augustine, FL 32084
(904) 826-4954
✔ PECOS2.7 mi
Andrew Lourens, APRN
Nurse Practitioner
NPI 1568956456
400 COLONNADE DR STE 160
Ponte Vedra, FL 32081
(904) 824-1020
✔ PECOS✔ Accepts Medicare18 mi
Milena Jguenti, MD
Internal Medicine
NPI 1932147402
28 OLD KINGS RD N UNIT A
Palm Coast, FL 32137
(904) 826-3469
✔ PECOS✔ Accepts Medicare22 mi
Michael Look, DO
Family Practice
NPI 1861677601
199 SOUTH HIGHWAY 17 SUITE B
East Palatka, FL 32131
(904) 826-3469
✔ PECOS✔ Accepts Medicare23 mi
See all 26 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2301991

Flagler Family Medicine PA · Saint Augustine, FL
Active · expires Apr 2, 2028
CLIA Number10D2301991
Laboratory TypePhysician Office
Certificate Effective DateApril 3, 2026
Certificate Expiration DateApril 2, 2028
Laboratory DirectorMichael J. Look
Laboratory Phone(904) 826-3469
Laboratory LocationFlagler Family Medicine PA6277 A1a South Unit 101 And 102, Saint Augustine, FL 32080
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2298583

Flagler Family Medicine PA · Saint Augustine, FL
Active · expires Feb 4, 2028
CLIA Number10D2298583
Laboratory TypePhysician Office
Certificate Effective DateFebruary 5, 2026
Certificate Expiration DateFebruary 4, 2028
Laboratory DirectorMichael J. Look
Laboratory Phone(904) 826-3469
Laboratory LocationFlagler Family Medicine PA105 South Park Blvd Suite 302C, Saint Augustine, FL 32086
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D1096294

Flagler Family Medicine PA · Saint Augustine, FL
Active · expires Mar 2, 2027
CLIA Number10D1096294
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2025
Certificate Expiration DateMarch 2, 2027
Laboratory DirectorMichael Look
Laboratory Phone(904) 826-3469
Laboratory LocationFlagler Family Medicine PA130 Health Park Blvd, Saint Augustine, FL 32086
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2014955

Flagler Family Medicine PA · Saint Augustine, FL
Expired · Oct 18, 2026
CLIA Number10D2014955
Laboratory TypePhysician Office
Certificate Effective DateOctober 19, 2024
Certificate Expiration DateOctober 18, 2026
Laboratory DirectorMichael Look
Laboratory Phone(904) 826-3469
Laboratory LocationFlagler Family Medicine PA315 W Town Pl Unit 1, Saint Augustine, FL 32092
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Flagler Family Medicine P A's NPI number?

The NPI number for Flagler Family Medicine P A is 1215080809. It was assigned to this organization in the NPPES registry on January 19, 2007.

Where is Flagler Family Medicine P A located?

Flagler Family Medicine P A is located at 130 Health Park Blvd, St Augustine, FL 32086. The listed phone number is (904) 826-3469.

What is Flagler Family Medicine P A's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Flagler Family Medicine P A enrolled in Medicare?

Yes. Flagler Family Medicine P A is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Flagler Family Medicine P A?

According to the CMS Revalidation Reassignment List (October 2026 release), 26 clinicians in 4 Medicare specialties reassign their Medicare billing to Flagler Family Medicine P A. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (11), Nurse Practitioner (11) and Internal Medicine (3). Of these, 13 practice at this address and 17 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Flagler Family Medicine P A hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Flagler Family Medicine P A accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Flagler Family Medicine P A 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.

When was this NPI record last updated?

The NPPES record for Flagler Family Medicine P A was last updated on July 23, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.