Mohamed Omar Radwan, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

ME110119 Issued in FL

Practice address

1325 San Marco Blvd
Reid Building, Ste 300
Jacksonville, FL 32207-8568

Phone

(904) 253-6910

Fax

(904) 253-6964

NPI assigned

Sep 25, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in CA

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

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scripps Health Inpatient Providers Medical Group IncGroup PAC ID 9436314762, 209 clinicians

La Jolla Pulmonary and Critical Care IncGroup PAC ID 7911908645, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
• Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503
• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mradwan80120@scrippshlth.medalliesdirect.net

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.

• La Jolla Pulmonary and Critical Care Inc.

  • Pulmonary Disease Physician
  • La Jolla, CA
  • NPI 1912076365
  Medicare reassignment Care Compare group NPD
• Scripps Health Inpatient Providers Medical Group Inc.

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1699043000

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Respiratory Critical Care and Sleep Medicine Associates,Inc

  • Pulmonary Disease Physician
  • Jacksonville, FL
  • NPI 1386622629
  NPD
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  dba Scripps Mercy Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD
• Baptist MD Anderson Cancer Physicians Inc

  dba Baptist Oncology Services Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Jacksonville, FL
  • NPI 1609286897
  NPD (past)
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  NPD (past)
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD (past)

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

• Scripps Health

  dba Scripps Memorial Hospital Encinitas

  • General Acute Care Hospital
  • Encinitas, CA
  • NPI 1700829199
  Care Compare affiliation
• Scripps Health

  dba Scripps Green Hospital

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  Care Compare affiliation
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  Care Compare affiliation

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1063746873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "REID BUILDING, STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "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": "1325 SAN MARCO BLVD",
            "address_2": "REID BUILDING, STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADWAN",
        "first_name": "MOHAMED",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-25",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME110119",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME110119",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME110119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003911100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "936658",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01364661",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID FOR OTHER INSURANCES",
            "identifier": "59-3385828",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14H00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "348958",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Radiology Consultants of Jacksonville MRI
• Radiology Health Imaging, LLC
• Radiology Specialists of North Florida
• Doreen Radjenovic, ARNP
• Blaine Radley, DDS
• Vener Sentones Rafael, RPT
• Anna M Rafanan, MD
• Kaitlin Danielle Rafay, NURSE PRACTITIONER
• Leah Marie Raffety-Clark, DPT
• Mackenzie Stanley Rafuls, RDN

• Pulmonary Disease Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pulmonary Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.