JONATHAN DIVINE D.O.
NPI 1710173968
Family Medicine in Jacksonville, FL

Q: What is Jonathan Divine's NPI number?

The NPI number for Jonathan Divine is 1710173968. It was assigned to this individual provider in the NPPES registry on September 21, 2007.

Q: What is Jonathan Divine's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jonathan Divine was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since September 21, 2007PECOS Enrolled

3059 EDGEWOOD AVE W, JACKSONVILLE, FL 32209(904) 647-3180 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Jonathan Divine D.o. NPPES

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

JONATHAN DIVINE D.O. (NPI 1710173968) is an individual family medicine provider in Jacksonville, Florida, licensed in Florida (OS 10858) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and is a graduate of West Virginia School Of Osteopathic Medicine (2007).

NPPES Registry Identity

NPI1710173968

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJONATHAN DIVINECredential: D.O.

Location Address3059 EDGEWOOD AVE WJacksonville, FL 32209-2207

Mailing Address3059 Edgewood Ave WJacksonville, FL 32209-2207 · (904) 647-3180

Phone(904) 647-3180

Sole ProprietorNo

Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 2007

Enumeration DateSeptember 21, 2007

Last NPPES UpdateOctober 8, 2025

NPPES CertifiedOctober 8, 2025

✔ NPI 1710173968 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 · OS 10858

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.

3059 EDGEWOOD AVE W, Jacksonville, FL 32209

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Oscar Health Maintenance Organization of Florida, Wellpoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Divine D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133311368

PECOS Enrollment IDI20101006001053

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.

Medicare Billing Reassignments

Medicare enrollment records show Jonathan Divine reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dedicated Senior Medical Center Of Florida, LLC

Same address

Specialist

3059 EDGEWOOD AVENUE WEST
Jacksonville, FL 32209

Reassigned Medicare billing, Florida enrollment
348 clinicians in this Medicare group

NPI 1033626122 (305) 628-6117

St Vincents Ambulatory Care Inc

4.1 mi

Neurological Surgery

2 SHIRCLIFF WAY, SUITE 600
Jacksonville, FL 32204

Reassigned Medicare billing, Florida enrollment
Medicare enrollment name: St Vincent's Ambulatory Care Inc
544 clinicians in this Medicare group

NPI 1417987124 (904) 308-6769

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

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.

418 services224 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.

175 services175 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.

117 services105 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

78 services72 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

77 services71 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.

36 services26 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 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 Clay County

Acute Care Hospitals · Middleburg, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100321

Location1670 St Vincents WayMiddleburg, FL 32068 · Clay County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32209 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

67%323 patients3/55-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)…

52%537 patients

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

65%699 patients4/55-star benchmark: 85%

Depression Utilization of the PHQ-9 Tool

The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit

Patients 4MonthsOfEnd: 59% · 101 patients

Patients 4MonthsOfStart: 50% · 139 patients

58%106 patients

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

42%307 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.

96%9,299 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…

34%1,294 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.

99%728 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.

96%1,800 patients4/55-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

39%1,113 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…

96%1,800 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…

51%1,800 patients3/55-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.

51%1,800 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 2

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

6 suppliers12 claims43 services$6.78 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

3 suppliers22 claims22 services$186.77 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 11

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

CHRISTIN BAGLEY

Nurse Practitioner (Family)