Rabie Ibrahim Adam-Eldien, M.D.
Individual provider Active NPI Nephrology Physician · Jacksonville, FL
NPI 1104873355 · NPPES record last updated Aug 13, 2020
Key facts
- NPI
- 1104873355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 55776 (TN)
- Practice address
- 4123 University Blvd S
Ste E
Jacksonville, FL 32216 - Phone
- (904) 744-4448
- Fax
- (904) 744-4048
- NPI assigned
- May 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
7685 103Rd St
Suite 1
Jacksonville, FL 32210-9326
Phone (904) 730-1225
Hospital & facility affiliations
- Bma - Saint Johns
- HCA Florida Orange Park Hospital
- Ascension St Vincent'S Riverside
- Baptist Health Medical Center - Jacksonville
- HCA Florida Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170725001594 | TN | Practitioner - Nephrology | 1658334610 | Reassigns benefits to 2 organizations |
| I20190510001891 | FL | Practitioner - Nephrology |
1658334610 |
Reassigns benefits to 4 organizations Practice locations: Jacksonville, FL |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME119980 | FL | MD | Internal Medicine Physician |
| 55776 | TN | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Jose Clinic, P.a. | Current |
Accepting new patients | |
| University of Florida Jacksonville Physicians Inc | Nephrology | Current |
Accepting new patients |
| River City Nephrology PLLC | Nephrology | Current |
Accepting new patients |
| Southeastern Physician Services PC | Internal Medicine | Current |
Accepting new patients |
| University of Florida Jacksonville Physicians, Inc. | Internal Medicine | Current | Accepting new patients |
| App of Tennessee HM, PLLC | Emergency Medicine | Current |
Accepting new patients |
| Ridgewood Physician Services, LLC | Hospitalist | Current |
Accepting new patients |
| Lake Wales Physician Services, LLC | Hospitalist | Current |
Accepting new patients |
| Boston University Family Medicine, Inc. | Past | Accepting new patients | |
| Naeem Haider | Nephrology | Past | Accepting new patients |
| First Coast Hospitalist P L | Internal Medicine | Past | Accepting new patients |
Locations
40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496
2449 University Blvd W
Jacksonville, FL 32217
Phone (904) 256-3330
7685 103rd St
Ste 1
Jacksonville, FL 32210
Phone (904) 771-1116
3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404
10614 Lem Turner Rd
Jacksonville, FL 32218
Phone (904) 768-8576
1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414
580 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3960
3599 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7600
4901 Richard St
Jacksonville, FL 32207
Phone (904) 425-0500
800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
410 S 11th St
Lake Wales, FL 33853
Phone (863) 676-1433
2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015
106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100
110 Hospital Dr
Jefferson Cty, TN 37760
Phone (865) 471-2431
5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000
726 McFarland St
Morristown, TN 37814
Phone (423) 522-6160
435 2nd St
Newport, TN 37821
Phone (423) 625-2200
2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
Interoperability endpoints
- https://api.platform.athenahealth.com/26160/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 55776 | TN | |
| Hospitalist Physician | 208M00000X | 55776 | TN | |
| Internal Medicine Physician | 207R00000X | ME119980 | FL | |
| Nephrology Physician | 207RN0300X | 55776 | TN | Yes |
Addresses
Primary practice location
4123 University Blvd S
Ste E
Jacksonville, FL 32216
Mailing address
4123 University Blvd S
Ste E
Jacksonville, FL 32216-4320
Phone (904) 744-4448
Other practice location 1
40100 Highway 27
Davenport, FL 33837-5906
Phone (863) 422-4971
Other practice location 2
110 Hospital Dr
Jefferson City, TN 37760-5281
Phone (865) 471-2500
Other practice location 3
435 2nd St
Newport, TN 37821-3703
Phone (423) 625-2200
Other practice location 4
410 S 11th St
Lake Wales, FL 33853-4256
Phone (863) 676-1433
Other practice location 5
726 McFarland St
Morristown, TN 37814-3989
Phone (423) 522-6000
Other providers in Jacksonville, FL
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- Chantelle Brielle Young Adaba
- Dorothy Dean Gentile Adair
- Michael Adalia
- Christopher Adalio
- Asher Adamec
- Vinicius Adami Vayego Fornazari
- Nicole Adamiak
- Noor Adamo
- Latricia Denise Adams-Durham
All providers in Jacksonville, FL · Nephrology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.