Larry Mastrogianakis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

65705 Issued in GA

Practice address

12428 San Jose Blvd
Ste 3
Jacksonville, FL 32223-8616

Phone

(904) 260-9495

Fax

(904) 260-3009

NPI assigned

Nov 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmastrogianakis2949254@carolinashealthcaresystem.direct-ci.com

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 Physician Services of Florida PA

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1558718635
  Medicare reassignment NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650

  Pediatrics

  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment NPD
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Pediatrics

  Medicare reassignment NPD
• Larry D Mastrogianakis, MD Pediatric and Adolescent Medicine

  • Pediatric Adolescent Medicine Physician
  • St Augustine, FL
  • NPI 1831970433
  NPD Authorized official
• St Vincents Ambulatory Care Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• The Medical Center of Central Georgia Inc

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1023090800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12428 SAN JOSE BLVD",
            "address_2": "STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238616",
            "telephone_number": "904-260-9495",
            "fax_number": "904-260-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12428 SAN JOSE BLVD",
            "address_2": "STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238616",
            "telephone_number": "904-260-9495",
            "fax_number": "904-260-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROGIANAKIS",
        "first_name": "LARRY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME44927",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "44927",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "65705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Anne Masters, RD
• Maggie Christine Masters
• Mark Masters, PH. D
• Tara Masterson
• Elan Elaine Mastin, DPT
• Masvida Health Care Solutions, LLC
• Tessa Davenport Mata, PA-C
• Alicia Beatriz Matayoshi, DMD
• Gautam Matcha, MD
• Taylor Diane Materia, BCBA

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.