Individual provider Active NPI

Antonio Desean Lozada

  • Surgical Critical Care Physician
  • Orange Park, FL
National Provider Identifier
1053677047
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
ME169115 Issued in FL
Practice address
1887 Kingsley Ave Ste 1900
Orange Park, FL 32073-4451
Phone
(904) 276-2549
Fax
(904) 276-9235
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 036145468 IL
Surgical Critical Care Physician 2086S0102X ME169115 FL Primary

Addresses

Primary practice location

1887 Kingsley Ave Ste 1900
Orange Park, FL 32073-4451

Mailing address

1887 Kingsley Ave Ste 1900
Orange Park, FL 32073-4451
Phone (904) 276-2549

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alozada14075@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180809004229 IL Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6305143504 Reassigns benefits to 1 organization
I20240826003781 FL Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 6305143504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Saint Louis University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Trauma Services LLCGroup PAC ID 3971985938, 92 clinicians

Practice addresses (Care Compare)

1887 Kingsley Ave
Suite 1900
Orange Park, FL 32073-4451
Phone (904) 276-2549

Hospital & facility affiliations

  • HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
  • HCA Florida Lake City Hospital Hospital, Lake City, FL, CCN 100156
  • HCA Florida Putnam Hospital Hospital, Palatka, FL, CCN 100232

Merit-based Incentive Payment System (MIPS)

Final score
73.88 of 100Reported as group
Quality
63.91
Improvement activities
40
Cost
77.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036145468ILMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Trauma Services, LLC Trauma Surgery CurrentSince Sep 1, 2024 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Jul 30, 2018 Accepting new patients
Southern Illinois Medical Services, NFP PastSince Jan 1, 2021 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

1887 Kingsley Ave
Ste 1900
Orange Park, FL 32073
Phone (904) 272-9981

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

305 W Jackson St
Ste 302
Carbondale, IL 62901
Phone (618) 457-3006

1239 E Main St
Carbondale, IL 62901

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: alozada14075@sih.direct-ci.com
  • Direct secure messaging: antonio.lozada@hca5.eclinicaldirectplus.com

Organizations & group practices 3

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 3

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1053677047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE STE 1900",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734451",
            "telephone_number": "904-276-2549",
            "fax_number": "904-276-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE STE 1900",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734451",
            "telephone_number": "904-276-2549",
            "fax_number": "904-276-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOZADA",
        "first_name": "ANTONIO",
        "middle_name": "DESEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036145468",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME169115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alozada14075@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.