Individual provider

Brent Mickley, PA

Physician Assistant Medicare enrolled

Brent Mickley, PA is a Physician Assistant in Jacksonville, FL, registered under NPI 1124034269.

Getting there

The practice address on file is 14534 OLD SAINT AUGUSTINE RD STE 3420, Jacksonville, FL 32258. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

14534 OLD SAINT AUGUSTINE RD STE 3420, Jacksonville, FL 32258 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
PA9103362 FL Physician Assistant primary
0010-05496 NC Physician Assistant

Licences are recorded in 2 states: FL, NC. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Physician Assistant
PAC ID
1254364300

Enrolled in Medicare 2 times, across 2 states:

StateEnrollment IDProvider type
Florida I20050919000196 Practitioner - Physician Assistant
North Carolina I20150406001094 Practitioner - Physician Assistant

Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. There are 2 separate enrolment records across 2 states (FL, NC). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Florida and North Carolina. The practice address on file is in Jacksonville, FL, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

FL Florida practice address
Licence
PA9103362
Specialty
Physician Assistant
Verify with the FL board →
NC North Carolina
Licence
0010-05496
Specialty
Physician Assistant
Verify with the NC board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Physician Assistant covers

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. NUCC Health Care Provider Taxonomy, code 363A00000X
Physician Assistants & Advanced Practice Nursing Providers Physician Assistant

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363A00000X Physician Assistant PA9103362 FL primary
363A00000X Physician Assistant 0010-05496 NC

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1124034269 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJul 31, 2006
Last updatedMar 31, 2020
StatusActive
Sole proprietorNo
CredentialPA
Practice address 14534 OLD SAINT AUGUSTINE RD STE 3420
Jacksonville, FL 32258
(904) 493-8001
Fax (904) 338-0852
Mailing address PO BOX 43667
Jacksonville, FL 32203
Other identifiers 018231000 · Medicaid (FL)
P01718560 · Other (FL)
The last update on file is Mar 31, 2020. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1124034269 passes the NPI check digit test The final digit 9 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 2 4 0 3 4 2 6
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 4 4 0 3 8 2 3

Sum = 51 · next multiple of 10 = 60 · check digit = 9 · actual last digit = 9

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1124034269?
NPI 1124034269 is the National Provider Identifier assigned to Brent Mickley, PA in Jacksonville, FL. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Physician Assistant cover?
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In…
How do I contact Brent Mickley, PA?
The phone number on file with NPPES is (904) 493-8001, last updated Mar 31, 2020. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Brent Mickley, PA accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1124034269 a valid number?
Yes. 1124034269 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.