RICHARD R PROIA MD
NPI 1902880826
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Jacksonville, FL

Active since December 05, 2005PECOS EnrolledAccepts Medicare Assignment
1824 KING ST STE 200, JACKSONVILLE, FL 32204(904) 384-3343(904) 400-6671 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 31, 2025, May 19, 2020, Jun 7, 2019 and 1 more (4 updates tracked since 2017).

About Richard R Proia Md NPPES

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

RICHARD R PROIA MD (NPI 1902880826) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Jacksonville, Florida, licensed in Florida (ME94028) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and is a graduate of Columbia University College Of Physicians And Surgeons (1997).

NPPES Registry Identity

NPI1902880826
Entity TypeIndividualMale
Primary Taxonomy208G00000X
Provider Legal NameRICHARD R PROIACredential: MD
Location Address1824 KING ST STE 200Jacksonville, FL 32204
Mailing Address1824 King St Ste 200Jacksonville, FL 32204 · (904) 384-3343 · Fax (904) 400-6671
Fax(904) 400-6671
Sole ProprietorNo
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 1997
Enumeration DateDecember 5, 2005
Last NPPES UpdateMarch 31, 20254 updates tracked since enumeration
NPPES CertifiedMarch 31, 2025
NPI 1902880826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
License Licensed in FL · ME94028
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
1824 KING ST STE 200, Jacksonville, FL 32204

Other Identifiers 1

Medicaid273595400FL

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Richard R Proia Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375563620
PECOS Enrollment IDI20051201000087
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
30 services30 patients
Replacement of aortic valve through the skin and femoral artery 33361
This procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.
26 services26 patients
Coronary artery bypass using artery graft, 1 graft 33533
A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.
24 services24 patients
Coronary artery bypass using vein or artery graft, 2 grafts 33518
A coronary artery bypass with 2 grafts is a surgery to improve blood flow to your heart. A surgeon takes a healthy vein or artery from your body and attaches it to the blocked coronary artery. This creates a new path for blood to flow, bypassing the blockage.
15 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension St Vincent's Riverside

Acute Care Hospitals · Jacksonville, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100040
Location1 Shircliff WayJacksonville, FL 32204 · Duval County
Emergency services

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32204 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
$171.84 typical visit price
range $56.00 – $171.84
Typical copayment $42.96 (range $14.00 – $42.96)
Most-billed visit code 99205
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.

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.

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%417 patients5/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
96%45 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
91%53 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
33%238 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
96%53 patients4/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 191 patients
0%191 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
11%53 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 11

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

Thoracic Surgery (Cardiothoracic Vascular Surgery)
1824 KING ST STE 200
JACKSONVILLE, FL 32204
Surgery (Vascular Surgery)
1824 KING ST STE 200
JACKSONVILLE, FL 32204
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1824 KING ST STE 200
JACKSONVILLE, FL 32204
Surgery
1824 KING ST STE 200
JACKSONVILLE, FL 32204
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1824 KING ST STE 200
JACKSONVILLE, FL 32204
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1824 KING ST STE 200
JACKSONVILLE, FL 32204
Physician Assistant
1824 KING ST STE 200
JACKSONVILLE, FL 32204
Registered Nurse
1824 KING ST STE 200
JACKSONVILLE, FL 32204

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 Richard Proia's NPI number?

The NPI number for Richard Proia is 1902880826. It was assigned to this individual provider in the NPPES registry on December 5, 2005.

Where is Richard Proia located?

Richard Proia practices at 1824 King St Ste 200, Jacksonville, FL 32204. The listed phone number is (904) 384-3343.

What is Richard Proia's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Richard Proia enrolled in Medicare?

Yes. Richard Proia is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Richard Proia accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 4 other insurers list Richard Proia 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 Richard Proia affiliated with any hospitals?

According to CMS data, Richard Proia is affiliated with Ascension St Vincent's Riverside and Baptist Health Medical Center - Jacksonville.

When was this NPI record last updated?

The NPPES record for Richard Proia was last updated on March 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.