Individual provider Active NPI

Hary T. Katz, MD

  • Pediatric Allergy/Immunology Physician
  • Jacksonville, FL
National Provider Identifier
1053322586
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
ME88948 Issued in FL
Practice address
4123 University Blvd. S.
Suite B
Jacksonville, FL 32216
Phone
(904) 636-9100
Fax
(904) 636-9102
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X ME88948 FL Primary

Addresses

Primary practice location

4123 University Blvd. S.
Suite B
Jacksonville, FL 32216

Mailing address

4123 University Blvd S.
Suite B
Jacksonville, FL 32216
Phone (904) 636-9100

Other identifiers 2

IdentifierTypeStateIssuer
494644845AMedicaidGA
270038700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040826000378 FL Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 9931174737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Miami, LM Miller School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Allergy and Asthma ConsultantsGroup PAC ID 9436256476, 6 clinicians

Practice addresses (Care Compare)

4123 University Blvd S
Suite B
Jacksonville, FL 32216-4320

4123 University S Blvd B
Jacksonville, FL 32216-4320
Phone (904) 636-9100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Allergy & Asthma Consultants CurrentSince Dec 15, 2009 Accepting new patients

Locations

12276 San Jose Blvd
Ste 609
Jacksonville, FL 32223
Phone (904) 636-9100

4123 University Blvd S
Ste B
Jacksonville, FL 32216
Phone (904) 636-9100

1406 Kingsley Ave
Ste D
Orange Park, FL 32073
Phone (904) 541-1780

135 Professional Dr
Ste 106
Ponte Vedra Beach, FL 32082
Phone (904) 636-9100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEHHBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FCEFAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IGJFCA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1053322586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY BLVD S.",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-636-9100",
            "fax_number": "904-636-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY BLVD. S.",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-636-9100",
            "fax_number": "904-636-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "HARY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "FL",
            "license": "ME88948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494644845A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270038700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.