NPIMap

Individual provider Active NPI

Jeffrey Paul Radabaugh, MD

  • Otolaryngology Physician
  • Jacksonville, FL
National Provider Identifier
1073806378
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME151381 Issued in FL
Practice address
836 Prudential Dr Ste 1601
Jacksonville, FL 32207-8343
Phone
(904) 396-8060
Fax
(904) 390-7385
NPI assigned
May 18, 2011
Last updated
Aug 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X S4846 TX
Otolaryngology Physician 207Y00000X R2620 KY
Otolaryngology Physician 207Y00000X ME151381 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1601
Jacksonville, FL 32207-8343

Mailing address

PO Box 41516
Jacksonville, FL 32203-1516
Phone (904) 202-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210812002350 FL Practitioner - Otolaryngology 6901114586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of South Carolina School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

836 Prudential Dr
Suite 1601
Jacksonville, FL 32207-8343
Phone (904) 396-8060

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME151381FLMDOtolaryngology Physician
R2620KYMDOtolaryngology Physician
S4846TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Sep 1, 2023 Accepting new patients
North Florida Surgeons, PA CurrentSince Sep 1, 2023 Accepting new patients
Baptist ENT Specialists Inc Otolaryngology PastSince Mar 24, 2025 Accepting new patients

Locations

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

14546 Old St Augustine Rd
Ste 401
Jacksonville, FL 32258
Phone (904) 268-5366

836 Prudential Dr
Ste 1601
Jacksonville, FL 32207
Phone (904) 396-2400

1370 13th Ave S
Ste 115
Jacksonville Beach, FL 32250
Phone (904) 202-6390

Interoperability endpoints

  • Direct secure messaging: jeffrey.radabaugh.1@9109.direct.athenahealth.com
  • Direct secure messaging: jradabaugh12599@direct.uth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1073806378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41516",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322031516",
            "telephone_number": "904-202-5111",
            "fax_number": "904-391-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078343",
            "telephone_number": "904-396-8060",
            "fax_number": "904-390-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADABAUGH",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "S4846",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "R2620",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME151381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.