Individual provider Active NPI

Donald Howard Auerbach, DO

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1104824325
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS3470 Issued in FL
Practice address
1255 Lila St
Jacksonville, FL 32208-3550
Phone
(904) 383-1930
NPI assigned
Jul 12, 2005
Last updated
Jun 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS3470 FL Primary

Addresses

Primary practice location

1255 Lila St
Jacksonville, FL 32208-3550

Mailing address

1255 Lila Street
Jacksonville, FL 32208
Phone (904) 524-8765

Other identifiers 1

IdentifierTypeStateIssuer
054385300MedicaidFL

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
I20070302000017 FL Practitioner - Family Practice 5496857997 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Jul 6, 2015 Accepting new patients
University of Florida Jacksonville Physicians Inc Family Medicine CurrentSince Jul 6, 2015 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 6, 2015 Accepting new patients
Sun Coast Hospital Inc Past Accepting new patients
SC Physicians LLC Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
University of Florida Jacksonville Physicians, Inc. Family Medicine Past Accepting new patients
Largo Physician Group, LLC PastSince Nov 4, 2012 Accepting new patients
Memorial Family Practice Associates, LLC Family Medicine Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients

Locations

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

5045 Soutel Dr
Ste 12
Jacksonville, FL 32208
Phone (904) 633-0500

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1104824325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 LILA STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32208",
            "telephone_number": "904-524-8765",
            "fax_number": "904-396-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 LILA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322083550",
            "telephone_number": "904-383-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUERBACH",
        "first_name": "DONALD",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS3470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054385300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.