Active NPI
Daniel Charles Neubauer
- General Practice Physician
- Jacksonville, FL
National Provider Identifier
1073938262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 1073938262
- Practice address
- 554 Keily St
Jacksonville, FL 32212 - Phone
- (757) 953-7550
- Fax
- (757) 953-7560
- NPI assigned
- Feb 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 1073938262 | VA | Primary |
Addresses
Primary practice location
554 Keily St
Jacksonville, FL 32212
Mailing address
554 Keily St
Jacksonville, FL 32212
Phone (757) 953-7550
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1073938262 | VA | MD | General Practice Physician |
Interoperability endpoints
- dneubauer821876@direct.vumc.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1073938262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "554 KEILY ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32212",
"telephone_number": "757-953-7550",
"fax_number": "757-953-7560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "554 KEILY ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32212",
"telephone_number": "757-953-7550",
"fax_number": "757-953-7560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUBAUER",
"first_name": "DANIEL",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-24",
"last_updated": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "1073938262",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 May 9, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.