Individual provider Active NPI

Mary Alderman, MD

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1093737306
Registry record updated Aug 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME72835 Issued in FL
Practice address
3599 University Blvd S
Building 300
Jacksonville, FL 32216-4252
Phone
(904) 399-5550
Fax
(904) 346-4334
NPI assigned
Jul 24, 2006
Last updated
Aug 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME72835 FL Primary

Addresses

Primary practice location

3599 University Blvd S
Building 300
Jacksonville, FL 32216-4252

Mailing address

3599 University Blvd S
Building 300
Jacksonville, FL 32216-4252
Phone (904) 399-5550

Other identifiers 3

IdentifierTypeStateIssuer
000943665BMedicaidGA
45096OtherFLBCBS
252452000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050510000462 FL Practitioner - Diagnostic Radiology 0941105332 Reassigns benefits to 2 organizations
I20181203000150 GA Practitioner - Diagnostic Radiology 0941105332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Florida College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1900 Tebeau St
Suite C
Waycross, GA 31501-6357
Phone (404) 851-6577

1902 Hickory Trace Dr
Fleming Island, FL 32003-8390
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

3599 University Blvd S
Suite 300
Jacksonville, FL 32216-4245
Phone (404) 662-2438

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
96.18
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME72835FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Aug 1, 2020 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Mar 30, 2024 Accepting new patients
Medlink Management Services Inc PastSince Nov 6, 2024 Accepting new patients
Doctors Imaging Group LLC Diagnostic Radiology Past Accepting new patients
Imaging Services of Jacksonville LLC Diagnostic Radiology Past Accepting new patients
Lower Keys Radiology Inc Diagnostic Radiology PastSince Jan 2, 2022 Accepting new patients
Shands Teaching Hospital and Clinics Inc Past Accepting new patients
Cypress Health Systems Florida Inc. Past Accepting new patients

Locations

1250 S 18th St
Fernandina Beach, FL 32034
Phone (904) 202-2087

14550 Old St Augustine Rd
Jacksonville, FL 32258
Phone (904) 202-5010

3599 University Blvd S
Ste 300
Jacksonville, FL 32216
Phone (904) 348-3879

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

8375 Dix Ellis Trl
Ste 201
Jacksonville, FL 32256
Phone (904) 399-5810

1350 13th Ave S
Jax Bch, FL 32250
Phone (904) 247-2900

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1900 Tebeau St
Ste C
Waycross, GA 31501

Organizations & group practices 9

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1093737306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "BUILDING 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-399-5550",
            "fax_number": "904-346-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "BUILDING 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-399-5550",
            "fax_number": "904-346-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDERMAN",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME72835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000943665B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45096",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252452000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.