Individual provider Active NPI

Rehan Mohammed Naseemuddin, M.D.

  • Gastroenterology Physician
  • Jacksonville, FL
National Provider Identifier
1083024715
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME144454 Issued in FL
Practice address
836 Prudential Dr Ste 801
Jacksonville, FL 32207-8258
Phone
(904) 288-0433
Fax
(904) 288-8996
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME144454 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 801
Jacksonville, FL 32207-8258

Mailing address

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 483-5826

Other identifiers 1

IdentifierTypeStateIssuer
107373200MedicaidFL

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
I20200728000528 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 7618190778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

1824 King St
Suite 300
Jacksonville, FL 32204-4736
Phone (386) 788-1242

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 398-7205

836 Prudential Dr
Suite 801
Jacksonville, FL 32207-8335
Phone (904) 288-0433

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
69.69
Promoting interoperability
89
Improvement activities
40
Cost
69.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy69
Upper gastrointestinal (GI) endoscopy for acid reflux118

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Borland Groover Clinic, PA Gastroenterology CurrentSince Dec 27, 2021 Accepting new patients

Locations

836 Prudential Dr
Ste 801
Jacksonville, FL 32207
Phone (904) 288-0433

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

52 Tuscan Way
Ste 203
St Augustine, FL 32092
Phone (904) 824-1450

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: rehan.naseemuddin@hca5.eclinicaldirectplus.com
  • Direct secure messaging: rehan.naseemuddin.p1@direct.bgclinic.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1083024715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-483-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 801",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078258",
            "telephone_number": "904-288-0433",
            "fax_number": "904-288-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASEEMUDDIN",
        "first_name": "REHAN",
        "middle_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME144454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107373200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.