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DR. WILLIE A PENNICK MD
NPI 1568426302
Family Medicine in Jacksonville, FL

Active since April 17, 2006PECOS EnrolledAccepts Medicare Assignment
1760 EDGEWOOD AVE W, SUITE B, JACKSONVILLE, FL 32208(904) 358-8480(904) 358-8460 Get Directions Write a Review

NPPES record last updated: July 2, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Willie A Pennick Md NPPES

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

DR. WILLIE A PENNICK MD (NPI 1568426302) is an individual family medicine provider in Jacksonville, Florida, licensed in Florida (ME53419) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and is a graduate of University Of Florida College Of Medicine (1985).

NPPES Registry Identity

NPI1568426302
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. WILLIE A PENNICKCredential: MD
Location Address1760 EDGEWOOD AVE W, SUITE BJacksonville, FL 32208-7209
Mailing Address1760 Edgewood Ave W, Suite BJacksonville, FL 32208-7209 · (904) 358-8480 · Fax (904) 358-8460
Phone(904) 358-8480
Fax(904) 358-8460
Sole ProprietorNo
Medical School CMSUniversity Of Florida College Of MedicineGraduated 1985
Enumeration DateApril 17, 2006
Last NPPES UpdateJuly 2, 2014
✔ NPI 1568426302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME53419
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.
1760 EDGEWOOD AVE W, Jacksonville, FL 32208
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Other Identifiers 3

Medicare UPIND21082FL
Medicaid062977400FL
Medicare ID-Type Unspecified05978YFL

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. Willie A Pennick Md 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 ID2365471711
PECOS Enrollment IDI20050806000017
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 9

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 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.
373 services137 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.
146 services100 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
130 services92 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.
98 services98 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
15 services13 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
15 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Baptist Medical Center - Nassau

Acute Care Hospitals · Fernandina Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100140
Location1250 S 18th StFernandina Beach, FL 32034 · Nassau 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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32208 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

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
81%277 patients4/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
31%145 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
77%485 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
37%188 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%7,370 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
36%911 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
96%195 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
97%826 patients5/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
40%594 patients2/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
98%826 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
19%826 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
23%826 patients
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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers21 claims61 services$6.00 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers11 claims16 services$1.15 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers19 claims19 services$67.48 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$28.31 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers13 claims13 services$202.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 8

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

MARIA SUSAN MARTINEZ LCSW
Social Worker (Clinical)
1760 EDGEWOOD AVE W
JACKSONVILLE, FL 32208
Duval County (904) 301-4900
PENNIC, WOOTEN& ASSOCIATES FAMILY MEDICAL CARE PA
Family Medicine
1760 EDGEWOOD AVE W, B
JACKSONVILLE, FL 32208
Duval County (904) 358-8480
MRS. DANNA CHARLENE MORRIS MN, APRN, FNP-C
Nurse Practitioner (Family)
1760 EDGEWOOD AVE W
JACKSONVILLE, FL 32208
Duval County (904) 253-1030
LINDA LOU TISDALE ARNP
Nurse Practitioner (Family)
1760 EDGEWOOD AVE W
JACKSONVILLE, FL 32208
Duval County (904) 301-4900
AARON THOMAS SHARP MD
Family Medicine
1760 EDGEWOOD AVE W
JACKSONVILLE, FL 32208
Duval County (940) 358-8480
FL DEPARTMENT OF HEALTH
Public Health or Welfare
1760 EDGEWOOD AVE W
JACKSONVILLE, FL 32208
Duval County (904) 253-1030
DR. JAMES L GENTRY MD
Pediatrics
1760 EDGEWOOD AVE W
JACKSONVILLE, FL 32208
Duval County (904) 301-4900
DR. KENNETH E NIXON MD
Family Medicine
1760 EDGEWOOD AVE W
JACKSONVILLE, FL 32208
Duval County (904) 253-1030

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 Willie Pennick's NPI number?

The NPI number for Willie Pennick is 1568426302. It was assigned to this individual provider in the NPPES registry on April 17, 2006.

Where is Willie Pennick located?

Willie Pennick practices at 1760 Edgewood Ave W Suite B, Jacksonville, FL 32208. The listed phone number is (904) 358-8480.

What is Willie Pennick's specialty?

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

Is Willie Pennick enrolled in Medicare?

Yes. Willie Pennick 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 Willie Pennick accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Willie Pennick 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 Willie Pennick affiliated with any hospitals?

According to CMS data, Willie Pennick is affiliated with Ascension St Vincent's Riverside, Baptist Medical Center - Nassau and Ascension St Vincent's Southside.

When was this NPI record last updated?

The NPPES record for Willie Pennick was last updated on July 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.