Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeffrey D Ricketts, PA

Individual provider Surgical Physician Assistant · NPI 1063495281

Jeffrey D Ricketts, PA is a Physician Assistant in Jacksonville, Florida. Qualified in 2005, 21 years ago. Practices with Emory Medical Care Foundation Inc, a 996-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
21
Licensed in
FL
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

836 Prudential Dr Ste 1804
Jacksonville, FL 32207
Phone: (904) 398-3888
Fax: (904) 400-6675
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9103298 (FL)

Record details

NPI number1063495281
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 22, 2005
Last updated in NPPESMay 10, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Emory Medical Care Foundation Inc — 996 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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