ISLAND DOCTORS INTRASTATE LLC
NPI 1568083889
Clinic/Center - Primary Care in Saint Augustine, FL
About Island Doctors Intrastate Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ISLAND DOCTORS INTRASTATE LLC (NPI 1568083889) is a healthcare organization registered as a primary care in Saint Augustine, Florida and active in the NPI registry since April 2020. The organization holds 2 active CLIA laboratory certificates and lists Roy H Hinman, Ceo And President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Island Doctors Intrastate Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
73Medicare enrollment records show 73 clinicians reassign Medicare billing to Island Doctors Intrastate LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 11 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 8
Nearest to this location (20)
See all 73Saint Augustine, FL 32080
St Augustine, FL 32080
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 2
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 10D0870484
Island Doctors · Saint Augustine, FLCertificate of Waiver 10D1015245
Island Doctors · Saint Augustine, FLFrequently 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 Island Doctors Intrastate LLC's NPI number?
The NPI number for Island Doctors Intrastate LLC is 1568083889. It was assigned to this organization in the NPPES registry on April 27, 2020.
Where is Island Doctors Intrastate LLC located?
Island Doctors Intrastate LLC is located at 100 Arricola Ave, Saint Augustine, FL 32080. The listed phone number is (904) 825-4368.
What is Island Doctors Intrastate LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Island Doctors Intrastate LLC enrolled in Medicare?
Yes. Island Doctors Intrastate LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Island Doctors Intrastate LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 73 clinicians in 8 Medicare specialties reassign their Medicare billing to Island Doctors Intrastate LLC. 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 Nurse Practitioner (28), General Practice (25) and Family Practice (9). Of these, 5 practice at this address and 11 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Island Doctors Intrastate LLC hold CLIA laboratory certificates?
Yes. 2 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.
When was this NPI record last updated?
The NPPES record for Island Doctors Intrastate LLC was last updated on April 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Island Doctors Intrastate Llc · NPI 1568083889
Primary Care organization in Saint Augustine, Florida. Organization record, active in the CMS NPPES registry since April 27, 2020.
## Identity
- **NPI:** 1568083889 (Entity type: Organization)
- **Enumerated:** April 27, 2020
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Roy Hinman, CEO AND PRESIDENT
## Practice location
- **Address:** 100 ARRICOLA AVE, Saint Augustine, FL 32080-4515
- **Phone:** (904) 825-4368 · **Fax:** (904) 825-9107
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 73 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (28), General Practice (25), Family Practice (9); 5 practice at this address and 11 within 10 miles; [full list](https://npiprofile.com/npi/1568083889/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 27, 2020
- **CLIA laboratory certificates:** 2 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1568083889) · Data from the CMS NPPES public registry.