FIRST COAST DERMATOLOGY P A
NPI 1699968651
Specialist in Jacksonville, FL
About First Coast Dermatology P A NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FIRST COAST DERMATOLOGY P A (NPI 1699968651) is a healthcare organization registered as a specialist in Jacksonville, Florida and active in the NPI registry since August 2007. The organization holds a CLIA Certificate of Compliance certificate valid through August 1, 2028 and lists Juan Antonio Rosario-collazo, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
First Coast Dermatology P A is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to First Coast Dermatology P A, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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
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 Compliance 10D1054592
First Coast Dermatology, PA · Jacksonville, 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 First Coast Dermatology P A's NPI number?
The NPI number for First Coast Dermatology P A is 1699968651. It was assigned to this organization in the NPPES registry on August 23, 2007.
Where is First Coast Dermatology P A located?
First Coast Dermatology P A is located at 4479 Baymeadows Rd, Jacksonville, FL 32217. The listed phone number is (904) 731-8300.
What is First Coast Dermatology P A's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is First Coast Dermatology P A enrolled in Medicare?
Yes. First Coast Dermatology P A is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through First Coast Dermatology P A?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to First Coast Dermatology P A. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does First Coast Dermatology P A hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 10D1054592) is associated with this NPI, valid through August 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does First Coast Dermatology P A accept?
Health plans from AvMed list First Coast Dermatology P A 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.
When was this NPI record last updated?
The NPPES record for First Coast Dermatology P A was last updated on October 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# First Coast Dermatology P A · NPI 1699968651
Specialist organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since August 23, 2007.
## Identity
- **NPI:** 1699968651 (Entity type: Organization)
- **Enumerated:** August 23, 2007
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Juan Rosario-Collazo, OWNER
## Practice location
- **Address:** 4479 BAYMEADOWS RD, Jacksonville, FL 32217-4716
- **Phone:** (904) 731-8300 · **Fax:** (904) 737-7901
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 6, 2016
- **Other identifiers:** Medicare PIN 99897
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1699968651) · Data from the CMS NPPES public registry.