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

Mary Tice, PA

Individual provider Medical Physician Assistant · NPI 1073594206

Mary Tice, PA is a Physician Assistant in Jacksonville, Florida. Qualified in 2003, 23 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
23
Licensed in
FL
In the registry since
2005
Specialties on file
2
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

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.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9102441 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA9102441 (FL)

Record details

NPI number1073594206
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 5, 2005
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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