DR. JOHN KELLY WACHIRA MD
NPI 1659699122
Internal Medicine - Pulmonary Disease in Jacksonville, FL

Active since May 09, 2010PECOS EnrolledAccepts Medicare Assignment
84.38/100
CMS Quality Rating
1325 SAN MARCO BLVD STE 300, JACKSONVILLE, FL 32207(904) 253-6910(904) 253-6964 Get Directions Write a Review

NPPES record last updated: October 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. John Kelly Wachira Md NPPES

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

DR. JOHN KELLY WACHIRA MD (NPI 1659699122) is an individual pulmonary disease provider in Jacksonville, Florida, licensed in Florida (ME131813) and active in the NPI registry since May 2010. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1659699122
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. JOHN KELLY WACHIRACredential: MD
Location Address1325 SAN MARCO BLVD STE 300Jacksonville, FL 32207-8567
Mailing Address1325 San Marco Blvd Ste 300Jacksonville, FL 32207-8567 · (904) 253-6910 · Fax (904) 253-6964
Fax(904) 253-6964
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateMay 9, 2010
Last NPPES UpdateOctober 27, 2022
NPPES CertifiedOctober 27, 2022
NPI 1659699122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in FL · ME131813
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedSpecialistTaxonomy 174400000X · License 7270 (NE)
Also ListedInternal MedicineTaxonomy 207R00000X · License ME131813 (FL)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License ME131813 (FL)
1325 SAN MARCO BLVD STE 300, Jacksonville, FL 32207

Other Identifiers 1

Medicaid21125600FL

Accepted 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. John Kelly Wachira 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 ID3375784531
PECOS Enrollment IDI20170805000179
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 23

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.
350 services197 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
249 services122 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
204 services33 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
182 services32 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
176 services80 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
77 services23 patients

Hospital Affiliations CMS Care Compare 3

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

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100117
Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County
Emergency services Birthing friendly

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32207 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
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.

84.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality71.4
Promoting Interoperability97
Improvement Activities40
Cost72.34

Referred Medical Equipment & Supplies CMS DME claims 15

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
5 suppliers22 claims22 services$34.29 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers13 claims13 services$66.84 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers12 claims47 services$16.28 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
7 suppliers24 claims24 services$46.02 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers21 claims21 services$14.30 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
4 suppliers15 claims15 services$9.30 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 20

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

Family Medicine (Geriatric Medicine)
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207
Internal Medicine (Pulmonary Disease)
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207
Physician Assistant
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207
Counselor (Mental Health)
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207
Internal Medicine (Critical Care Medicine)
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207
Nurse Practitioner (Acute Care)
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207
Internal Medicine (Geriatric Medicine)
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207
Psychiatry & Neurology (Psychiatry)
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL 32207

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 John Wachira's NPI number?

The NPI number for John Wachira is 1659699122. It was assigned to this individual provider in the NPPES registry on May 9, 2010.

Where is John Wachira located?

John Wachira practices at 1325 San Marco Blvd Ste 300, Jacksonville, FL 32207. The listed phone number is (904) 253-6910.

What is John Wachira's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is John Wachira enrolled in Medicare?

Yes. John Wachira 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 John Wachira accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list John Wachira 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 John Wachira affiliated with any hospitals?

According to CMS data, John Wachira is affiliated with Baptist Health Medical Center - Jacksonville, Baptist Medical Center Beaches and Baptist Medical Center - Nassau.

When was this NPI record last updated?

The NPPES record for John Wachira was last updated on October 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.