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DR. JEREMIAH DANIEL PATRICK DMD
NPI 1841845161
Dentist - Endodontics in Fort Walton Beach, FL

Active since August 04, 2019Opted out of Medicare · through May 31, 2028
207 PELHAM RD, FORT WALTON BEACH, FL 32547(850) 808-3636 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 2, 2026, Aug 12, 2021, Aug 4, 2019 (3 updates tracked since 2019).

About Dr. Jeremiah Daniel Patrick Dmd NPPES

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

DR. JEREMIAH DANIEL PATRICK DMD (NPI 1841845161) is an individual endodontics provider in Fort Walton Beach, Florida, licensed in Florida (DN24125) and active in the NPI registry since August 2019. He has opted out of Medicare through May 31, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1841845161
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameDR. JEREMIAH DANIEL PATRICKCredential: DMD
Location Address207 PELHAM RDFort Walton Beach, FL 32547-3604
Mailing Address207 Pelham RdFort Walton Beach, FL 32547-3604 · (850) 808-3636
Phone(850) 808-3636
Sole ProprietorNo
Enumeration DateAugust 4, 2019
Last NPPES UpdateFebruary 2, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
✔ NPI 1841845161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in FL · DN24125
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
207 PELHAM RD, Fort Walton Beach, FL 32547
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jeremiah Daniel Patrick Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 31, 2024 through May 31, 2028.

Opt-Out Effective DateMay 31, 2024
Opt-Out In Effect ThroughMay 31, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32547 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
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

JEREMIAH D. PATRICK, D.M.D., P.A.
Dentist (Endodontics)
207 PELHAM RD
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 808-3636
DR. RODRICK HEATH DEASON D.M.D.
Dentist (Endodontics)
207 PELHAM RD
FORT WALTON BEACH, FL 32547
Okaloosa County (850) 863-3636

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 Jeremiah Patrick's NPI number?

The NPI number for Jeremiah Patrick is 1841845161. It was assigned to this individual provider in the NPPES registry on August 4, 2019.

Where is Jeremiah Patrick located?

Jeremiah Patrick practices at 207 Pelham Rd, Fort Walton Beach, FL 32547. The listed phone number is (850) 808-3636.

What is Jeremiah Patrick's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Jeremiah Patrick enrolled in Medicare?

No. Jeremiah Patrick has opted out of Medicare through May 31, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jeremiah Patrick was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.