Michael B Ibach, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME67895 Issued in FL

Practice address

1375 Roberts Dr
Ste 204
Jacksonville Beach, FL 32250-3210

Phone

(904) 247-0056

Fax

(904) 241-0065

NPI assigned

May 15, 2006

Last updated

May 24, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

GastroenterologyAlso: Internal Medicine

Education

University of South Florida College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score

78.94 of 100Reported as group

Quality

69.69

Promoting interoperability

89

Improvement activities

40

Cost

69.28

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: michael.ibach.p1@direct.bgclinic.nextgenshare.com

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.

• Borland Groover Clinic, PA

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1881644912
  Medicare reassignment Care Compare group NPD
• Medical Specialty Clinic P.C.

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1104877703

  Gastroenterology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1053362723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-398-3262",
            "fax_number": "904-265-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 ROBERTS DR",
            "address_2": "STE 204",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503210",
            "telephone_number": "904-247-0056",
            "fax_number": "904-241-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBACH",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "26687",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME67895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003230300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14AW4",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Hostetler, LMT
• Katie Carlson Howard, CCC-SLP
• Michael Hubbard
• Brian Hunt
• Ajla Hurem, ARNP
• Ideal Dental - Jacksonville Beach
• Im Sulzbacher Center for the Homeless Inc (Beaches Community Healthcare)
• In the Pink Boutique, Inc. (In the Pink)
• In the Pink Boutique, Inc.
• Infinity Health Systems Inc

• Gastroenterology Physician in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.
• 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.