NPIMap

Individual provider Active NPI

Rene Uriel Pulido, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1033357553
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME103456 Issued in FL
Practice address
2570 Atlantic Blvd
Jacksonville, FL 32207-3604
Phone
(904) 647-8576
Fax
(904) 253-3098
NPI assigned
Jan 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Family Medicine Physician 207Q00000X ME103456 FL Primary

Addresses

Primary practice location

2570 Atlantic Blvd
Jacksonville, FL 32207-3604

Mailing address

2570 Atlantic Blvd
Jacksonville, FL 32207-3604
Phone (904) 647-8576

Other practice location 1

2624 Atlantic Blvd Ste 1
Jacksonville, FL 32207-3633
Phone (904) 513-3240

Other identifiers 7

IdentifierTypeStateIssuer
004248300OtherFLMEDIPASS
338970OtherFLAVMED
000934500MedicaidFL
148KPOtherFLBLUE CROSS BLUE SHIELD
6683250001OtherFLNSC DMEPOS
9818064OtherFLCIGNA
004248300MedicaidFL

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
I20091218000214 FL Practitioner - Family Practice 0547300709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emed Urgent and Primary Care IncGroup PAC ID 9830381664, 5 clinicians

Practice addresses (Care Compare)

2624 Atlantic Blvd
Suite 1
Jacksonville, FL 32207-3633
Phone (904) 513-3240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME103456FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Health and Nutrition LLC Clinic/Center CurrentSince Sep 9, 2020 Accepting new patients
Emed Urgent and Primary Care Inc Past Accepting new patients
Emed Urgent and Primary Care PA Past Accepting new patients

Locations

2624 Atlantic Blvd
Ste 6
Jacksonville, FL 32207
Phone (904) 513-3240

2624 Atlantic Blvd
Jacksonville, FL 32207
Phone (904) 513-3240

2624 Atlantic Blvd
Ste 1
Jacksonville, FL 32207
Phone (904) 413-3360

Interoperability endpoints

  • Direct secure messaging: rene.pulido@emed.eclinicaldirectplus.com

Organizations & group practices 4

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": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1033357553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073604",
            "telephone_number": "904-647-8576",
            "fax_number": "904-253-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073604",
            "telephone_number": "904-647-8576",
            "fax_number": "904-253-3098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2624 Atlantic Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322073633",
            "country_code": "US",
            "telephone_number": "904-513-3240",
            "fax_number": "904-379-2911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULIDO",
        "first_name": "RENE",
        "middle_name": "URIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME103456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIPASS",
            "identifier": "004248300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "338970",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000934500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "148KP",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC DMEPOS",
            "identifier": "6683250001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9818064",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004248300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.