Eric H Schallen, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME87153 Issued in FL

Practice address

3599 University Blvd S
Building 300
Jacksonville, FL 32216-4252

Phone

(904) 399-5550

Fax

(904) 346-4334

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

University of Michigan Medical School, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
• HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226
• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179

Merit-based Incentive Payment System (MIPS)

Final score

96.75 of 100Reported as group

Quality

96.18

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

78.06 of 100Reported as group

Quality

72.79

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 33)

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.

• Mori Bean and Brooks Inc

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070
  Medicare reassignment Care Compare group NPD
• Northside Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1013960657

  FL

  Medicare reassignment Care Compare group NPD
• Georgia Radiology Imaging Consultants, LLC

  • Diagnostic Radiology Physician
  • Harvey, IL
  • NPI 1831461771

  GA

  Medicare reassignment
• Imaging Services of Jacksonville LLC

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1154586964
  NPD (past)
• Northside Imaging LLC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1316394976
  NPD (past)

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

• Baptist Medical Center of Nassau Inc

  • General Acute Care Hospital
  • Fernandina Beach, FL
  • NPI 1518024462
  Care Compare affiliation
• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Memorial Healthcare Group Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation
• Orange Park Medical Center, Inc.

  • General Acute Care Hospital
  • Orange Park, FL
  • NPI 1689611501
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1194747402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "BUILDING 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-399-5550",
            "fax_number": "904-346-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "BUILDING 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-399-5550",
            "fax_number": "904-346-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLEN",
        "first_name": "ERIC",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME87153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "29153",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081848606A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266598100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon H Schafer
• Nicole Schafer, RBT
• Ashley D Schaffer, LM, CPM
• Catherine Abigail Schaffer, NP
• Olivia Anne Schalk
• Konika Schallen, MD
• Cathy Ann Schan, PA
• David C Schantz, A.P.
• Jennifer Keese Schantz, CNM
• Andrew Schare, MD

• Diagnostic Radiology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.
• 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.