Jack Osullivan, DO
NPI 1649845264ActiveIndividual· General Practice· Jacksonville, FL
General Practice (DO) in Jacksonville, Florida, trained at Nova Southeastern College of Osteo Medicine (class of 2021). Enrolled in Medicare as practitioner - family practice.
Overview
| NPI | 1649845264 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | No |
| NPI issued | May 25, 2021 |
| Last updated in NPPES | Sep 22, 2023 |
| Certified by provider | Sep 22, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | 0102207445 | VA |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
| Military Health Care Provider | 171000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Family Practice (VA) |
|---|
Education and affiliations
| Medical school | Nova Southeastern College of Osteo Medicine |
|---|---|
| Graduation year | 2021 |
| Medicare specialty | Family Practice |
Medical groups
- Se Virginia Value Based Care LLCNorfolk, VA · 161 clinicians
- Mid-Atlantic Post Acute and Long Term Care PLLCNorfolk, VA · 143 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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