NPIMap

Individual provider Active NPI

Christopher Rafael Larrazabal, MD

  • Internal Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1093770075
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0071203 Issued in FL
Practice address
500 Memorial Cir
Suite a
Ormond Beach, FL 32174-5071
Phone
(386) 676-2779
Fax
(386) 676-2811
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0071203 FL Primary

Addresses

Primary practice location

500 Memorial Cir
Suite a
Ormond Beach, FL 32174-5071

Mailing address

500 Memorial Cir
Suite a
Ormond Beach, FL 32174-5071
Phone (386) 676-2779

Other identifiers 1

IdentifierTypeStateIssuer
250682300MedicaidFL

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
I20090706000160 FL Practitioner - Internal Medicine 9638220544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

500 Memorial Cir
Suite a
Ormond Beach, FL 32174-5054
Phone (386) 676-2779

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Adventhealth Home Health Home health agency, Ormond Beach, FL, CCN 107408
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0071203FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lana Medical Care P.a. Internal Medicine CurrentSince May 1, 2003 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

500 Memorial Cir
Ste A
Ormond Beach, FL 32174
Phone (386) 290-9505

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGGAED/Endpoint/JGGAED

Organizations & group practices 2

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 8

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1093770075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEMORIAL CIR",
            "address_2": "SUITE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745071",
            "telephone_number": "386-676-2779",
            "fax_number": "386-676-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEMORIAL CIR",
            "address_2": "SUITE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745071",
            "telephone_number": "386-676-2779",
            "fax_number": "386-676-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARRAZABAL",
        "first_name": "CHRISTOPHER",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0071203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250682300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.