Individual provider Active NPI

Raymond Manuel Pumarejo, M.D.

  • Pulmonary Disease Physician
  • Jacksonville, FL
National Provider Identifier
1104806892
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME 75751 Issued in FL
Practice address
425 N. Lee St, # 203
Jacksonville, FL 32204-1128
Phone
(904) 354-8200
Fax
(904) 354-1340
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME 75751 FL Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME75751 FL

Addresses

Primary practice location

425 N. Lee St, # 203
Jacksonville, FL 32204-1128

Mailing address

425 North Lee Street, Suite 203
Jacksonville, FL 32204
Phone (904) 354-8200

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
I20120111000787 FL Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 7911174164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

2300 Park Ave
Suite 205
Orange Park, FL 32073-5573
Phone (904) 272-0384

Hospital & facility affiliations

  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040
  • Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 75751FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc Pulmonary Disease CurrentSince Nov 21, 2011 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Nov 21, 2011 Accepting new patients

Locations

425 N Lee St
Ste 203
Jacksonville, FL 32204
Phone (904) 354-8200

4203 Belfort Rd
Ste 108
Jacksonville, FL 32216
Phone (904) 450-6460

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

3 Shircliff Way
Ste 625
Jacksonville, FL 32204
Phone (904) 308-6900

2300 Park Ave
Ste 205
Orange Park, FL 32073
Phone (904) 272-0384

300 Saint Elizabeth Way
Ste 270
St Johns, FL 32259
Phone (904) 296-3103

Interoperability endpoints

  • Direct secure messaging: raymond.pumarejo.1@8967.direct.athenahealth.com

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 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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1104806892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 NORTH LEE STREET, SUITE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-354-8200",
            "fax_number": "904-354-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N. LEE ST, # 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041128",
            "telephone_number": "904-354-8200",
            "fax_number": "904-354-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMAREJO",
        "first_name": "RAYMOND",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME 75751",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME75751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.