NPIMap

Individual provider Active NPI

Patrick Semaan Antoun, MD

  • Cardiovascular Disease Physician
  • Jacksonville, FL
National Provider Identifier
1184884850
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME118156 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 383-1011
Fax
(904) 244-3102
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11013939A IN
Cardiovascular Disease Physician 207RC0000X ME118156 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-3660

Other identifiers 3

IdentifierTypeStateIssuer
003147062AMedicaidGA
14U8DOtherFLBCBS
011135500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140519001048 FL Practitioner - Interventional CardiologyPractitioner - Other (Physician)Practitioner - Cardiovascular Disease (Cardiology) 9931322062 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

4205 Belfort Rd
Jacksonville, FL 32216-1471
Phone (904) 296-0278

Hospital & facility affiliations

  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040
  • Ascension St Vincent'S St Johns County Hospital, St. Johns, FL, CCN 100361
  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting39
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013939AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc Cardiovascular Disease CurrentSince Oct 1, 2017 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2014 Accepting new patients
University of Florida Jacksonville Physicians Inc Cardiovascular Disease CurrentSince Jul 1, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 1, 2017 Accepting new patients
Cardiology Interpreters Inc CurrentSince Apr 16, 2018 Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

4205 Belfort Rd
Ste 2069
Jacksonville, FL 32216
Phone (904) 296-0278

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

2025 Indian Rocks Rd S
Largo, FL 33774
Phone (727) 581-9474

Interoperability endpoints

  • Direct secure messaging: patrick.antoun.1@8967.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1184884850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-383-1011",
            "fax_number": "904-244-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOUN",
        "first_name": "PATRICK",
        "middle_name": "SEMAAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11013939A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME118156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003147062A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14U8D",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011135500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.