Active NPI
Paul H Dillahunt II, MD
- Nuclear Cardiology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Cardiology Physician
- License
- ME23103
- Practice address
- 836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344 - Phone
- (904) 398-0125
- Fax
- (904) 398-1832
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | ME23103 | FL | |
| Nuclear Cardiology Physician | 207UN0901X | ME23103 | FL | Primary |
| Cardiovascular Disease Physician | 207RC0000X | ME23103 | FL |
Addresses
Primary practice location
836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344
Mailing address
PO Box 746652
Atlanta, GA 30374-6652
Phone (904) 202-2092
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036771100 | Medicaid | FL |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 95.44 of 100
- Quality
- 84.21
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME23103 | FL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ecg Associates of Jacksonville P a | Current | Accepting new patients | |
| Baptist Cardiology, Inc. | Cardiovascular Disease | Current | Accepting new patients |
| Memorial Ekg Associates | Past | Accepting new patients | |
| Southern Heart Group, P.a. | Past | Accepting new patients | |
| Southern Heart Group | Cardiovascular Disease | Past | Accepting new patients |
Locations
1348 S 18th St
Ste 200
Fernandina Beach, FL 32034
Phone (904) 202-6683
1250 S 18th St
Fernandina Beach, FL 32034
Phone (904) 202-2087
820 Prudential Dr
Ste 615
Jacksonville, FL 32207
836 Prudential Dr
Ste 1700
Jacksonville, FL 32207
Phone (904) 398-0125
820 Prudential Dr
Ste 112
Jacksonville, FL 32207
Phone (904) 396-5996
800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000
3599 University Blvd S
Ste 1106
Jacksonville, FL 32216
Phone (904) 398-3760
Organizations & group practices 5
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.
-
- Cardiovascular Disease Physician
- Jacksonville, FL
- NPI 1760751598
-
- Cardiology Technician
- Jacksonville, FL
- NPI 1679796395
-
- Specialist
- Jacksonville, FL
- NPI 1427014216
-
- Cardiology Technician
- Jacksonville, FL
- NPI 1992928618
-
- Cardiovascular Disease Physician
- Jacksonville, FL
- NPI 1962484220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1184680985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746652",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746652",
"telephone_number": "904-202-2092",
"fax_number": "904-376-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "836 PRUDENTIAL DR STE 1700",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078344",
"telephone_number": "904-398-0125",
"fax_number": "904-398-1832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLAHUNT",
"first_name": "PAUL",
"middle_name": "H",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "FL",
"license": "ME23103",
"primary": false
},
{
"code": "207UN0901X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Cardiology",
"state": "FL",
"license": "ME23103",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "ME23103",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036771100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.