John Ellis Agens Jr., MD

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

ME87099 Issued in FL

Practice address

4449 Meandering Way
Fsu Seniorhealth at Wok
Tallahassee, FL 32308-5740

Phone

(850) 644-1543

Fax

(850) 645-0577

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Florida Medical Practice Plan Inc

  • General Practice Physician
  • Tallahassee, FL
  • NPI 1326386293
  Medicare reassignment NPD

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1144287087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3064300",
            "address_2": "1115 WEST CALL STREET, SUITE 1121-C",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323064300",
            "telephone_number": "850-645-9350",
            "fax_number": "850-645-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4449 MEANDERING WAY",
            "address_2": "FSU SENIORHEALTH AT WOK",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085740",
            "telephone_number": "850-644-1543",
            "fax_number": "850-645-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGENS",
        "first_name": "JOHN",
        "middle_name": "ELLIS",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 87099",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME87099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Affordable Dentures & Implants - Tallahassee IV, P.a.
• Anju Agarwal, M.D.
• Carmen P Agboton, PHARMD
• Melody S Agbunag, M.D.
• Rodrigo Abat Agbunag Jr., M.D.
• Kristina Porte Aggabao
• Janice Agner
• Labresia Agnew
• Amanda Nicole Agosto
• Jason Eric Agran, M.D., PH.D.

• Geriatric Medicine (Internal Medicine) Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.