Individual provider Active NPI

Natasha Eliz, MD

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1053334375
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME90460 Issued in FL
Practice address
4203 Belfort Rd
Suite 204
Jacksonville, FL 32216-1463
Phone
(904) 296-5688
Fax
(904) 296-5699
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME90460 FL Primary

Addresses

Primary practice location

4203 Belfort Rd
Suite 204
Jacksonville, FL 32216-1463

Mailing address

4203 Belfort Rd
Suite 204
Jacksonville, FL 32216-1463
Phone (904) 296-5688

Other identifiers 1

IdentifierTypeStateIssuer
270331900MedicaidFL

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
I20040916000327 FL Practitioner - Obstetrics/Gynecology 0244207108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical School at Houston, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB Hospitalist Group LLCGroup PAC ID 5193866838, 127 clinicians

Practice addresses (Care Compare)

4201 Belfort Rd
Jacksonville, FL 32216-1431
Phone (800) 967-2289

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
OB Hospitalist Group LLC CurrentSince Jul 23, 2018 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince May 2, 2011 Accepting new patients
OB Hospitalist Group LLC CurrentSince Jul 23, 2018 Accepting new patients
OB Hospitalist Group LLC Current Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince May 2, 2011 Accepting new patients

Locations

4203 Belfort Rd
Ste 204
Jacksonville, FL 32216
Phone (904) 296-5688

4205 Belfort Rd
Ste 4020
Jacksonville, FL 32216
Phone (904) 450-6020

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1053334375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 BELFORT RD",
            "address_2": "SUITE 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161463",
            "telephone_number": "904-296-5688",
            "fax_number": "904-296-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 BELFORT RD",
            "address_2": "SUITE 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161463",
            "telephone_number": "904-296-5688",
            "fax_number": "904-296-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZ",
        "first_name": "NATASHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME90460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270331900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.