DR. ASHLEY JESSICA FALK M.D.
NPI 1386671063
Family Medicine in Winter Haven, FL

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since June 27, 2006PECOS EnrolledAccepts Medicare Assignment

1201 1ST ST S STE 100A, WINTER HAVEN, FL 33880(863) 280-6080(863) 229-7587 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 2, 2021, Mar 10, 2020, Jan 29, 2020 and 1 more (4 updates tracked since 2016).

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About Dr. Ashley Jessica Falk M.d. NPPES

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

DR. ASHLEY JESSICA FALK M.D. (NPI 1386671063) is an individual family medicine provider in Winter Haven, Florida, licensed in Florida (ME124584) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with Winter Haven Hospital, and is a graduate of University Of Minnesota Medical School (2003).

NPPES Registry Identity

NPI1386671063

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. ASHLEY JESSICA FALKCredential: M.D.

Location Address1201 1ST ST S STE 100AWinter Haven, FL 33880-3904

Mailing Address1201 1st St S Ste 100aWinter Haven, FL 33880-3904 · (863) 280-6080 · Fax (863) 229-7587

Phone(863) 280-6080

Fax(863) 229-7587

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 2003

Enumeration DateJune 27, 2006

Last NPPES UpdateMarch 30, 20224 updates tracked since enumeration

NPPES CertifiedMarch 30, 2022

✔ NPI 1386671063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in FL · ME124584✔ Licensed in NE · 23082

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.

1201 1ST ST S STE 100A, Winter Haven, FL 33880

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Other Identifiers 1

Medicaid017913200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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. Ashley Jessica Falk 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 ID1355498395

PECOS Enrollment IDI20150824000205

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 3

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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 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.

61 services47 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.

26 services23 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Winter Haven Hospital

Acute Care Hospitals · Winter Haven, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100052

Location200 Ave F NEWinter Haven, FL 33881 · Polk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33880 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.

Reported Quality Measures

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…

100%177 patients5/55-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 16

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

DR. NATHAN P FALK MD

Family Medicine