Individual provider Active NPI

Radames A Oliver, MD

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1063518710
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0067906 Issued in FL
Practice address
3625 University Blvd S
Jacksonville, FL 32216-4207
Phone
(904) 399-6811
Fax
(904) 346-0113
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0067906 FL Primary

Addresses

Primary practice location

3625 University Blvd S
Jacksonville, FL 32216-4207

Mailing address

PO Box 860554
Orlando, FL 32886-0554
Phone (904) 346-3606

Other identifiers 1

IdentifierTypeStateIssuer
27374OtherFLBCBS

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
I20100908000777 FL Practitioner - Emergency Medicine 4789709189 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0067906FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

6477 103rd St
Jacksonville, FL 32210
Phone (904) 639-8517

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1063518710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860554",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328860554",
            "telephone_number": "904-346-3606",
            "fax_number": "904-346-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-399-6811",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "RADAMES",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0067906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27374",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.