Individual provider Active NPI

Andrew Lim, M.D.

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1003017021
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
TRN11193 Issued in FL
Practice address
1504 Dunsford Rd
Jacksonville, FL 32207-4208
Phone
(904) 253-3734
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TRN11193 FL Primary

Addresses

Primary practice location

1504 Dunsford Rd
Jacksonville, FL 32207-4208

Mailing address

1504 Dunsford Rd
Jacksonville, FL 32207-4208
Phone (904) 253-3734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130711000747 CT Practitioner - Emergency Medicine 7416095120 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.62 of 100Reported as group
Quality
84.96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN11193FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Fairfield County, LLC Emergency Medicine CurrentSince Nov 18, 2021 Accepting new patients
Usacs of Connecticut, LLC Emergency Medicine CurrentSince Jan 29, 2020 Accepting new patients
Bristol Hospital Multi Specialty Group, Inc CurrentSince Dec 1, 2024 Accepting new patients
Darling Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

539 Farmington Ave
Bristol, CT 06010
Phone (860) 314-6046

41 Brewster Rd
Bristol, CT 06010
Phone (800) 585-3000

32 Strawberry Hill Ct
Stamford, CT 06902
Phone (203) 276-2000

1 Hospital Plz
Stamford, CT 06902
Phone (203) 276-4925

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1003017021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 DUNSFORD RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074208",
            "telephone_number": "904-253-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 DUNSFORD RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074208",
            "telephone_number": "904-253-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "TRN11193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.