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KATHRYN TYRRELL DEGOURSEY PA-C
NPI 1659384766
Physician Assistant in Jacksonville, FL

Active since August 14, 2006PECOS EnrolledAccepts Medicare Assignment
3550 UNIVERSITY BLVD S STE 302, JACKSONVILLE, FL 32216(904) 733-4444(904) 733-5377 Get Directions Write a Review

NPPES record last updated: February 26, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 26, 2019, Dec 26, 2018 (2 updates tracked since 2018).

About Kathryn Tyrrell Degoursey Pa-c NPPES

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

KATHRYN TYRRELL DEGOURSEY PA-C (NPI 1659384766) is an individual physician assistant in Jacksonville, Florida, licensed in Florida (PA1974) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1659384766
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKATHRYN TYRRELL DEGOURSEYCredential: PA-C
Location Address3550 UNIVERSITY BLVD S STE 302Jacksonville, FL 32216
Mailing Address10058 Baymeadows RdJacksonville, FL 32256-7177 · (904) 636-5400 · Fax (904) 928-0654
Phone(904) 733-4444
Fax(904) 733-5377
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateAugust 14, 2006
Last NPPES UpdateFebruary 26, 20192 updates tracked since enumeration
✔ NPI 1659384766 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA1974
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.
3550 UNIVERSITY BLVD S STE 302, Jacksonville, FL 32216
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Other Names 1

Former Name (1)Kathryn Tyrrell Peabody Pa-c

Secondary Practice Location 1

Location 110058 Baymeadows RdJacksonville, FL 32256-7177 · Phone (904) 636-5400 · Fax (904) 928-0654

Other Identifiers 2

Medicaid009353600FL
Medicaid018008600FL

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

Kathryn Tyrrell Degoursey Pa-c 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 ID1254310527
PECOS Enrollment IDI20040719001496
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.

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 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 32216 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.

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 Kathryn Degoursey's NPI number?

The NPI number for Kathryn Degoursey is 1659384766. It was assigned to this individual provider in the NPPES registry on August 14, 2006. The provider is also known as Kathryn Tyrrell Peabody Pa-C.

Where is Kathryn Degoursey located?

Kathryn Degoursey practices at 3550 University Blvd S Ste 302, Jacksonville, FL 32216. The listed phone number is (904) 733-4444.

What is Kathryn Degoursey's specialty?

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

Is Kathryn Degoursey enrolled in Medicare?

Yes. Kathryn Degoursey 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 Kathryn Degoursey accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama and AvMed list Kathryn Degoursey 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 Kathryn Degoursey affiliated with any hospitals?

According to CMS data, Kathryn Degoursey is affiliated with Baptist Health Medical Center - Jacksonville and Ascension St Vincent's Southside.

When was this NPI record last updated?

The NPPES record for Kathryn Degoursey was last updated on February 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.