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DR. DEBBIE A. BERLIN M.D.
NPI 1245288471
Surgery in Orange Park, FL

Active since May 04, 2006PECOS EnrolledAccepts Medicare Assignment
79.26/100
CMS Quality Rating
1555 KINGSLEY AVE, SUITE 503, ORANGE PARK, FL 32073(904) 278-5088(904) 264-4910 Get Directions Write a Review

NPPES record last updated: June 23, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Debbie A. Berlin M.d. NPPES

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

DR. DEBBIE A. BERLIN M.D. (NPI 1245288471) is an individual surgery provider in Orange Park, Florida, licensed in Florida (ME90493) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Albert Einstein College Of Medicine Of Yeshiva University (1995).

NPPES Registry Identity

NPI1245288471
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameDR. DEBBIE A. BERLINCredential: M.D.
Location Address1555 KINGSLEY AVE, SUITE 503Orange Park, FL 32073-9207
Mailing Address11945 San Jose Blvd, Bldg 300Jacksonville, FL 32223-1627 · (904) 396-1725 · Fax (904) 399-1717
Phone(904) 278-5088
Fax(904) 264-4910
Sole ProprietorNo
Medical School CMSAlbert Einstein College Of Medicine Of Yeshiva UniversityGraduated 1995
Enumeration DateMay 4, 2006
Last NPPES UpdateJune 23, 2011
✔ NPI 1245288471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in FL · ME90493
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.

1555 KINGSLEY AVE, Orange Park, FL 32073
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Other Identifiers 8

Medicare UPINU3258A
Medicaid274974200FL
Medicare UPINI15795
Other5953872Cigna
Other294216Avmed
Other50705Bcbs Fl
OtherP00146174FL · Railroad Medicare
Other7431565Aetna

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

Dr. Debbie A. Berlin M.d. 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 ID749258655
PECOS Enrollment IDI20040920000207
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 10

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.

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.
101 services61 patients
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.
63 services63 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.
62 services59 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
43 services25 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.
34 services28 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
25 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Ascension St Vincent's Clay County

Acute Care Hospitals · Middleburg, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100321
Location1670 St Vincents WayMiddleburg, FL 32068 · Clay County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32073 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

Advance Care Plan
64%392 patients3/55-star benchmark: 100%
Breast Cancer Screening
34%154 patients2/55-star benchmark: 93%
Cervical Cancer Screening
0%149 patients1/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
30%64 patients2/55-star benchmark: 87%
Colorectal Cancer Screening
9%345 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
62%26 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
74%965 patients3/55-star benchmark: 100%
e-Prescribing
96%133 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
2%238 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
26%550 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
0%534 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
18%701 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 70% · 494 patients
Patients screened: 71% · 494 patients
79%28 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
52%397 patients2/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
81%26 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 251 patients
Patients totalRate: 1% · 251 patients
1%251 patients4/55-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.

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.

DR. JACK E COHEN DO
Orthopaedic Surgery
1555 KINGSLEY AVE, STE 201
ORANGE PARK, FL 32073
Clay County (904) 278-0432
JOHN D BRINKMAN M.D.
Surgery
1555 KINGSLEY AVE, SUITE 503
ORANGE PARK, FL 32073
Clay County (904) 278-5088
DR. MICHAEL S. GILLIGAN M.D.
Surgery
1555 KINGSLEY AVE, SUITE 503
ORANGE PARK, FL 32073
Clay County (904) 278-5088
INTERNAL MEDICINE ASSOCIATES OF NORTHEAST FLORIDA PA
Internal Medicine
1555 KINGSLEY AVE, SUITE 604
ORANGE PARK, FL 32073
Clay County (904) 541-0670
JOAN DUNSTONE O LEARY MD
Dermatology
1555 KINGSLEY AVE, SUITE 401
ORANGE PARK, FL 32073
Clay County (904) 278-3100
EMANUEL MARTINEZ MD AND ASSOCIATES
Psychiatry & Neurology (Psychiatry)
1555 KINGSLEY AVE, SUITE 101
ORANGE PARK, FL 32073
Clay County (904) 278-4999
JOAN D OLEARY MD PL
Dermatology
1555 KINGSLEY AVE, SUITE 401
ORANGE PARK, FL 32073
Clay County (904) 278-3100
PETER JOHN PITOCCHI M.D.
Internal Medicine
1555 KINGSLEY AVE, SUITE 501
ORANGE PARK, FL 32073
Clay County (904) 264-2402

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 Debbie Berlin's NPI number?

The NPI number for Debbie Berlin is 1245288471. It was assigned to this individual provider in the NPPES registry on May 4, 2006.

Where is Debbie Berlin located?

Debbie Berlin practices at 1555 Kingsley Ave Suite 503, Orange Park, FL 32073. The listed phone number is (904) 278-5088.

What is Debbie Berlin's specialty?

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

Is Debbie Berlin enrolled in Medicare?

Yes. Debbie Berlin 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 Debbie Berlin accept?

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

According to CMS data, Debbie Berlin is affiliated with Baptist Health Medical Center - Jacksonville and Ascension St Vincent's Clay County.

When was this NPI record last updated?

The NPPES record for Debbie Berlin was last updated on June 23, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.