Organization Active NPI

Florida Heart Center PA

  • Specialist
  • Orange Park, FL
National Provider Identifier
1043427107
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FLORIDA HEART CENTER PA
Practice address
1518 Kingsley Ave
Orange Park, FL 32073-4511
Phone
(904) 269-1664
Fax
(904) 264-4085
NPI assigned
May 17, 2007
Last updated
Mar 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Authorized official

Name
Dr. Hossein Ramezani, MDNPI 1962464685
Title
President
Phone
(904) 269-1664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

1518 Kingsley Ave
Orange Park, FL 32073-4511

Mailing address

PO Box 365
Orange Park, FL 32067-0365
Phone (904) 269-1664

Other identifiers 1

IdentifierTypeStateIssuer
040894800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110628000885 FL Part B Supplier - Clinic/Group Practice 9234317934 Receives reassigned benefits from 1 practitioner
Practice locations: Orange Park, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0267144Florida Heart Center, PA, Hossein Ramezani1518 Kingsley Ave, Orange Park, FL 32073Certificate of waiverMay 10, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1043427107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320670365",
            "telephone_number": "904-269-1664",
            "fax_number": "904-264-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734511",
            "telephone_number": "904-269-1664",
            "fax_number": "904-264-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HEART CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "RAMEZANI",
        "authorized_official_first_name": "HOSSEIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-269-1664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040894800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.