LOGAN SCOTT LAUDERDALE
NPI 1427730126
Physician Assistant in Jacksonville, FL

Q: What is Logan Lauderdale's NPI number?

The NPI number for Logan Lauderdale is 1427730126. It was assigned to this individual provider in the NPPES registry on August 2, 2023.

Q: What is Logan Lauderdale's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Logan Lauderdale was last updated on July 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since August 02, 2023PECOS Enrolled

2 SHIRCLIFF WAY STE 605, JACKSONVILLE, FL 32204(904) 634-0640(904) 634-0203 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Logan Scott Lauderdale NPPES

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

LOGAN SCOTT LAUDERDALE (NPI 1427730126) is an individual physician assistant in Jacksonville, Florida, licensed in Florida (PA9118127) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and maintains 11 additional practice locations.

NPPES Registry Identity

NPI1427730126

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameLOGAN SCOTT LAUDERDALE

Location Address2 SHIRCLIFF WAY STE 605Jacksonville, FL 32204-4762

Mailing Address6800 Southpoint Pkwy Ste 300Jacksonville, FL 32216-8203 · (904) 634-0640 · Fax (904) 634-0203

Phone(904) 634-0640

Fax(904) 634-0203

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateAugust 2, 2023

Last NPPES UpdateJuly 28, 2025

NPPES CertifiedJuly 28, 2025

✔ NPI 1427730126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in FL · PA9118127

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2 SHIRCLIFF WAY STE 605, Jacksonville, FL 32204

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Secondary Practice Locations 11

Location 14565 US Highway 17 Ste 17Fleming Island, FL 32003-4842 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 215255 Max Legget Pkwy Ste 5300Jacksonville, FL 32218-7274 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 36675 Corporate Center Pkwy Ste 115Jacksonville, FL 32216-8088 · Phone (904) 245-8910

Location 410475 Centurion Pkwy N Ste 220Jacksonville, FL 32256-5004 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 54268 Oldfield Crossing Dr Ste 201Jacksonville, FL 32223-8800 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 63055 County Road 210 W Ste 210St Johns, FL 32259-7000 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 7216 Southpark Cir E Ste 216St Augustine, FL 32086-5135 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 81690 US Highway 1 S Ste FSt Augustine, FL 32084-6024 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 92627 Riverside Ave Ste 300Jacksonville, FL 32204-4717 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 10232 Ponte Vedra Park DrPonte Vedra Beach, FL 32082-6600 · Phone (904) 634-0640 · Fax (904) 634-0203

Location 112300 Park Ave Ste 206Orange Park, FL 32073-5573 · Phone (904) 634-0640 · Fax (904) 634-0203

Other Identifiers 1

Medicaid122689800FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Logan Scott Lauderdale is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8426493719

PECOS Enrollment IDI20240226004188

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 12

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.

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.

162 services122 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

84 services57 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

69 services42 patients

X-ray of thigh bone, minimum 2 views 73552

An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.

43 services29 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

38 services23 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.

37 services35 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

35 services14 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

33 services23 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.

22 services22 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

Treatment of broken neck of thigh bone with bone implant 27245

This procedure involves repairing a fractured thigh bone by inserting a bone implant. The implant helps stabilize the bone, allowing it to heal correctly. It's performed under anesthesia and requires a hospital stay for recovery.

15 services15 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.

14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Ascension St Vincent's Riverside

Acute Care Hospitals · Jacksonville, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100040

Location1 Shircliff WayJacksonville, FL 32204 · Duval County

Emergency services

Ascension St Vincent's Southside

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100307

Location4201 Belfort RdJacksonville, FL 32216 · 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

Ascension St Vincent's St Johns County

Acute Care Hospitals · St Johns, FL

OwnershipVoluntary non-profit - Private

CMS Certification Number100361

Location205 Trinity WaySt Johns, FL 32259 · St. Johns County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32204 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.

Other Providers at the Same Location NPPES 7

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

DR. FARID A. HAKIM M.D.

Orthopaedic Surgery