Individual provider Active NPI

Tenzin Ngawang, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1063305696
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11038123 Issued in FL
Practice address
1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535
Phone
(904) 253-6910
Fax
(904) 253-6964
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP032652 PA
Acute Care Nurse Practitioner 363LA2100X 11038123 FL Primary

Addresses

Primary practice location

1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535

Mailing address

1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535
Phone (904) 253-6910

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251222002860 FL Practitioner - Nurse Practitioner 5597250076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1325 San Marco Blvd
Jacksonville, FL 32207-8568
Phone (904) 253-6910

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11038123FLMDAcute Care Nurse Practitioner
SP032652PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Respiratory Critical Care and Sleep Medicine Associates,Inc CurrentSince Dec 1, 2025 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

1443 San Marco Blvd
Ste 101
Jacksonville, FL 32207
Phone (904) 253-6910

1325 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 253-6910

Organizations & group practices 2

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 1

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": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1063305696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 SAN MARCO BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078535",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 SAN MARCO BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078535",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGAWANG",
        "first_name": "TENZIN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP032652",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11038123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.