DR. JACOB SUDDUTH MD
NPI 1821790593
Student in an Organized Health Care Education/Training Program in Port St Lucie, FL
About Dr. Jacob Sudduth Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACOB SUDDUTH MD (NPI 1821790593) is an individual student in an organized health care education/training program in Port St Lucie, Florida and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, is affiliated with Fairview Park Hospital, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jacob Sudduth Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jacob Sudduth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Aventura, FL 33180
- Reassigned Medicare billing, Florida enrollment
- 1,912 clinicians in this Medicare group
Savannah, GA 31404
- Reassigned Medicare billing, Georgia enrollment
- 29 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Fairview Park Hospital
Acute Care Hospitals · Dublin, GAOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORT ST LUCIE, FL 34952
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 Jacob Sudduth's NPI number?
The NPI number for Jacob Sudduth is 1821790593. It was assigned to this individual provider in the NPPES registry on March 20, 2023.
Where is Jacob Sudduth located?
Jacob Sudduth practices at 1800 SE Tiffany Ave, Port St Lucie, FL 34952. The listed phone number is (772) 335-4000.
What is Jacob Sudduth's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jacob Sudduth enrolled in Medicare?
Yes. Jacob Sudduth is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jacob Sudduth's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Sudduth reassigns Medicare benefits to 2 organizations: Emergency Medicine Services Of Fl, LLC (Aventura, FL) and Emergency Medicine Services Of Ga, LLC (Savannah, GA). Each 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 Jacob Sudduth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacob Sudduth accept?
Health plans from Oscar Health Maintenance Organization of Florida list Jacob Sudduth 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 Jacob Sudduth affiliated with any hospitals?
According to CMS data, Jacob Sudduth is affiliated with Fairview Park Hospital.
When was this NPI record last updated?
The NPPES record for Jacob Sudduth was last updated on March 20, 2023. 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.
# Dr. Jacob Sudduth, MD · NPI 1821790593
Student in an Organized Health Care Education/Training Program provider in Port St Lucie, Florida. Individual provider, active in the CMS NPPES registry since March 20, 2023.
## Identity
- **NPI:** 1821790593 (Entity type: Individual)
- **Enumerated:** March 20, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1800 SE TIFFANY AVE, Port St Lucie, FL 34952-7521
- **Phone:** (772) 335-4000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Emergency Medicine Services Of Fl, LLC (NPI 1043917180, Aventura, FL); Emergency Medicine Services Of Ga, LLC (NPI 1437017084, Savannah, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** March 20, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1821790593) · Data from the CMS NPPES public registry.