JACKSONVILLE CONCIERGE MEDICINE LLC
NPI 1891681037
Clinic/Center - Multi-Specialty in Jacksonville, FL
About Jacksonville Concierge Medicine Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSONVILLE CONCIERGE MEDICINE LLC (NPI 1891681037) is a healthcare organization registered as a multi-specialty in Jacksonville, Florida and active in the NPI registry since June 2025. The organization maintains a secondary practice location in Jacksonville and lists Kyle Mikals, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacksonville Concierge Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jacksonville Concierge Medicine LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jacksonville Concierge Medicine LLC's NPI number?
The NPI number for Jacksonville Concierge Medicine LLC is 1891681037. It was assigned to this organization in the NPPES registry on June 16, 2025.
Where is Jacksonville Concierge Medicine LLC located?
Jacksonville Concierge Medicine LLC is located at 7643 Gate Pkwy Ste 104-909, Jacksonville, FL 32256. The listed phone number is (904) 925-8540.
What is Jacksonville Concierge Medicine LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Jacksonville Concierge Medicine LLC enrolled in Medicare?
Yes. Jacksonville Concierge Medicine LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jacksonville Concierge Medicine LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Jacksonville Concierge Medicine LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jacksonville Concierge Medicine LLC was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Jacksonville Concierge Medicine Llc · NPI 1891681037
Multi-Specialty organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since June 16, 2025.
## Identity
- **NPI:** 1891681037 (Entity type: Organization)
- **Enumerated:** June 16, 2025
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Kyle Mikals, OWNER
## Practice location
- **Address:** 7643 GATE PKWY STE 104-909, Jacksonville, FL 32256-3092
- **Phone:** (904) 925-8540
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 26, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1891681037) · Data from the CMS NPPES public registry.