Michelle Susan Madjar, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LE-00038831 Issued in OH

Practice address

1639 Atlantic Blvd
Jacksonville, FL 32207-3346

Phone

(904) 224-1171

NPI assigned

Oct 1, 2021

Last updated

Aug 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beal Dermatology, PLLCGroup PAC ID 0941639884, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beal Dermatology, PLLC

  dba Jacksonville Dermatology & Cosmetic Surgery

  • Dermatology Physician
  • Jacksonville, FL
  • NPI 1841825791
  Medicare reassignment Care Compare group NPD
• Leavitt Medical Associates of Florida Inc

  dba Advanced Dermatology And Cosmetic Surgery

  • Dermatology Physician
  • Heathrow, FL
  • NPI 1528097284
  NPD (past)

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1174295760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10640 SATORI LN APT 413",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568096",
            "telephone_number": "440-212-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073346",
            "telephone_number": "904-224-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9828 Juniper Ct",
            "address_purpose": "LOCATION",
            "city": "Strongsville",
            "state": "OH",
            "postal_code": "441362606",
            "country_code": "US",
            "telephone_number": "440-212-2306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADJAR",
        "first_name": "MICHELLE",
        "middle_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "LE-00038831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vadim Lev Madfis, M.D.
• Harry Madhanagopal, D.O.
• Colleen Madison
• Jade Madison
• Trenton R Madison, MD
• Prita S Madkaiker, MD
• Satyen P. Madkaiker, MD
• Aileen Madriaga, PHARMD
• Jennifer Madrid
• Karen Madrid, NP

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.