Active NPI
Janeen H Paul, MD
- Psychiatry Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME163678
- Practice address
- 1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032 - Phone
- (833) 351-8255
- NPI assigned
- Mar 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036-103100 | IL | |
| Psychiatry Physician | 2084P0800X | 319816 | NY | |
| Psychiatry Physician | 2084P0800X | ME163678 | FL | Primary |
Addresses
Primary practice location
1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032
Mailing address
109 W 27TH St Ste 5S
New York, NY 10001-6208
Phone (917) 634-5311
Other practice location 1
109 W 27th St Ste 5S
New York, NY 10001-6208
Phone (917) 634-5311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01633221 | Other | IL | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, NY, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255
1301 Riverplace Blvd
Suite 800
Jacksonville, FL 32207-9032
Phone (833) 351-8255
250 Pkwy Dr
Suite 150
Lincolnshire, IL 60069-4340
Phone (917) 634-5311
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-103100 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD FL Psychiatry Services PA | Psychiatry | Current | Accepting new patients |
| MCCD Psychiatry Services PLLC | Psychiatry | Current | Accepting new patients |
Locations
1301 Riverplace Blvd
Jacksonville, FL 32207
1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040
250 Parkway Dr
Ste 150
Lincolnshire, IL 60069
Phone (847) 480-1346
109 W 27th St
#55
New York, NY 10001
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
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": "1141603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704412800000",
"number": "1073580387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 W 27TH ST STE 5S",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100016208",
"telephone_number": "917-634-5311",
"fax_number": "888-815-3583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 RIVERPLACE BLVD STE 800",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322079032",
"telephone_number": "833-351-8255"
}
],
"practiceLocations": [
{
"address_1": "109 W 27th St Ste 5S",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100016208",
"country_code": "US",
"telephone_number": "917-634-5311",
"fax_number": "888-815-3583",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAUL",
"first_name": "JANEEN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-06",
"last_updated": "2024-01-05",
"certification_date": "2024-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036-103100",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "319816",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME163678",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "01633221",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.