SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
NPI 1881179638
Orthopaedic Surgery in Fleming Island, FL

Q: What is Southeast Orthopedic Specialists, LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Active since September 27, 2018

4565 US HIGHWAY 17 STE 200, FLEMING ISLAND, FL 32003(904) 634-0640(904) 634-0203 Get Directions Write a Review

NPPES record last updated: December 12, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 12, 2022, Dec 14, 2021, Sep 27, 2018 (3 updates tracked since 2018).

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About Southeast Orthopedic Specialists, Llc NPPES

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

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC (NPI 1881179638) is a healthcare organization registered as an orthopaedic surgery in Fleming Island, Florida and active in the NPI registry since September 2018. The organization lists Brett Puckett, Vp, as its authorized official.

NPPES Registry Identity

NPI1881179638

Entity TypeOrganization

Primary Taxonomy207X00000X

Legal Business NameSOUTHEAST ORTHOPEDIC SPECIALISTS, LLC

Location Address4565 US HIGHWAY 17 STE 200Fleming Island, FL 32003-4823

Mailing Address6800 Southpoint Pkwy Ste 300Jacksonville, FL 32216-8203 · (904) 394-1282

Phone(904) 634-0640

Fax(904) 634-0203

Organization SubpartNo

Authorized OfficialBrett PuckettVp · (904) 394-1282

Enumeration DateSeptember 27, 2018

Last NPPES UpdateDecember 12, 20223 updates tracked since enumeration

NPPES CertifiedDecember 12, 2022

✔ NPI 1881179638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedSpecialistTaxonomy 174400000X

4565 US HIGHWAY 17 STE 200, Fleming Island, FL 32003

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness, Ambetter from Buckeye Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southeast Orthopedic Specialists, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateFloridaEnrollment IDO20190305003220DME · Physician - General PracticeDue dateFebruary 28, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 18

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

JAMES BRANDON CAUSEY DPT

Physical Therapist