HEATHER PUTNAM PAC
NPI 1730432170
Physician Assistant - Surgical in Jacksonville, FL

Q: What is Heather Putnam's NPI number?

The NPI number for Heather Putnam is 1730432170. It was assigned to this individual provider in the NPPES registry on October 23, 2012.

Q: What is Heather Putnam's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Heather Putnam was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 October 23, 2012PECOS Enrolled

76.2/100

CMS Quality Rating

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 24, 2026, Aug 31, 2020, Dec 13, 2017 (3 updates tracked since 2017).

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About Heather Putnam Pac NPPES

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

HEATHER PUTNAM PAC (NPI 1730432170) is an individual surgical provider in Jacksonville, Florida, licensed in Florida (PA9106882) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730432170

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameHEATHER PUTNAMCredential: PAC

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865

Phone(904) 953-2000

Sole ProprietorNo

Enumeration DateOctober 23, 2012

Last NPPES UpdateMarch 24, 20263 updates tracked since enumeration

NPPES CertifiedMarch 24, 2026

✔ NPI 1730432170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in FL · PA9106882

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Heather Putnam Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 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.

76.2/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

69.33

Promoting Interoperability

100

Improvement Activities

Cost

51.32

Referred Medical Equipment & Supplies CMS DME claims

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

Dynamic adjustable knee extension / flexion device, includes soft interface material E1810

DME-Other DME · category DE000N

1 supplier15 claims15 services$83.75 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

KATHERINE L WALSH PA-C/MPH

Physician Assistant