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

Jonathan Forest Balog, DO

Individual provider Family Medicine Physician · NPI 1417214289

Jonathan Forest Balog, DO is a Family Practice in Jacksonville, Florida. Graduated from Nova Southeastern College of Osteo Medicine in 2012, 14 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
14
Trained at
Nova Southeastern College of Osteo Medicine
Licensed in
FL
In the registry since
2012
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 550 Durbin Pavilion Dr Ste G101, Jacksonville, FL 32259-4135 — (904) 770-2095

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence OS12395 (FL)

Record details

NPI number1417214289
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 18, 2012
Last updated in NPPESOctober 30, 2023
Certification dateOctober 30, 2023
Mailing address200 1st St Sw, Rochester, MN 55905-0001

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolNOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated 2012 (14 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Jacksonville