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

Mr. Brent S Mickley, PA

Individual provider Physician Assistant · NPI 1124034269

Mr. Brent S Mickley, PA is a Physician Assistant in Jacksonville, Florida. Qualified in 2005, 21 years ago. Practices with Baptist Cardiology, Inc, a 99-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida and North Carolina.

Years since qualifying
21
Licensed in
FL, NC
In the registry since
2006
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

14534 Old Saint Augustine Rd Ste 3420
Jacksonville, FL 32258-2616
Phone: (904) 493-8001
Fax: (904) 338-0852
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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 PA9103362 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 0010-05496 (NC)

Record details

NPI number1124034269
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 31, 2006
Last updated in NPPESMarch 31, 2020
Certification dateMarch 31, 2020

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 Baptist Cardiology, Inc. — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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