NPIMap

Individual provider Active NPI

Andre D.C.P. Macedo Dias, M.D.

  • Cardiovascular Disease Physician
  • Jacksonville, FL
National Provider Identifier
1013221282
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME136812 Issued in FL
Practice address
11236 Baptist Health Dr Ste 310
Jacksonville, FL 32218
Phone
(904) 224-9309
Fax
(904) 764-0086
NPI assigned
Jul 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD454365 PA
Internal Medicine Physician 207R00000X 052065 CT
Nuclear Cardiology Physician 207UN0901X ME136812 FL
Cardiovascular Disease Physician 207RC0000X ME136812 FL Primary

Addresses

Primary practice location

11236 Baptist Health Dr Ste 310
Jacksonville, FL 32218

Mailing address

PO Box 43667
Jacksonville, FL 32203-3667
Phone (904) 720-0599

Other practice location 1

836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344
Phone (904) 398-0125

Other names 1

  • Andre Macedo Dias Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829002249 FL Practitioner - Cardiovascular Disease (Cardiology) 4486877412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Cardiology, Inc.Group PAC ID 2466614581, 98 clinicians

Practice addresses (Care Compare)

11236 Baptist Health Dr
Suite 310
Jacksonville, FL 32218-2989
Phone (904) 224-9303

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
052065CTMDInternal Medicine Physician
ME136812FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Cardiology, Inc. Cardiovascular Disease CurrentSince Sep 1, 2018 Accepting new patients
Ecg Associates of Jacksonville P a CurrentSince Sep 30, 2019 Accepting new patients

Locations

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

11236 Baptist Health Dr
Ste 310
Jacksonville, FL 32218
Phone (904) 224-9303

836 Prudential Dr
Ste 1700
Jacksonville, FL 32207
Phone (904) 398-0125

Interoperability endpoints

  • Direct secure messaging: amacedodias28123@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 2

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1013221282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43667",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322033667",
            "telephone_number": "904-720-0599",
            "fax_number": "904-376-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11236 BAPTIST HEALTH DR STE 310",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32218",
            "telephone_number": "904-224-9309",
            "fax_number": "904-764-0086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 Prudential Dr Ste 1700",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078344",
            "country_code": "US",
            "telephone_number": "904-398-0125",
            "fax_number": "904-398-1832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACEDO DIAS",
        "first_name": "ANDRE",
        "middle_name": "D.C.P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-30",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD454365",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "052065",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "FL",
            "license": "ME136812",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME136812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDRE",
            "last_name": "MACEDO DIAS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.