NPIMap

Organization Active NPI

Nabr Medical Group PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Ponte Vedra, FL
National Provider Identifier
1093469280
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
NABR MEDICAL GROUP PLLC
Practice address
4210 Valley Ridge Blvd Ste 131
Ponte Vedra, FL 32081-5183
Phone
(866) 687-6227
Fax
(866) 687-6227
NPI assigned
Feb 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Marc Arenas, MDNPI 1871908970
Title
Owner
Phone
(866) 687-6227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

4210 Valley Ridge Blvd Ste 131
Ponte Vedra, FL 32081-5183

Mailing address

4210 Valley Ridge Blvd Ste 131
Ponte Vedra, FL 32081-5183
Phone (866) 687-6227

Other practice location 1

58 Spanish Creek Dr
Ponte Vedra, FL 32081-6169
Phone (787) 567-3922

Other names 1

  • NABR Medical Group PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220503002916 FL Part B Supplier - Clinic/Group Practice 7911394374 Receives reassigned benefits from 5 practitioners
Practice locations: Ponte Vedra, FL

National Provider Directory

National Provider Directory

Locations

4210 Valley Ridge Blvd
Ste 148
Ponte Vedra, FL 32081
Phone (866) 687-6227

4210 Valley Ridge Blvd
Ste 131
Ponte Vedra, FL 32081
Phone (866) 687-6227

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1093469280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 VALLEY RIDGE BLVD STE 131",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815183",
            "telephone_number": "866-687-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 VALLEY RIDGE BLVD STE 131",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815183",
            "telephone_number": "866-687-6227",
            "fax_number": "866-687-6227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 Spanish Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra",
            "state": "FL",
            "postal_code": "320816169",
            "country_code": "US",
            "telephone_number": "787-567-3922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NABR MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-07",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "ARENAS",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-687-6227",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NABR Medical Group PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "NABR Medical Group PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.