Imtiaz Rasul, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME-112178 Issued in FL

Practice address

10175 Fortune Pkwy
Suite 206
Jacksonville, FL 32256-6746

Phone

(904) 379-8748

Fax

(904) 379-8796

NPI assigned

Dec 12, 2008

Sex

Male

Sole proprietor

Yes

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Jacksonville Psychiatric Association Inc

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1205261765
  Medicare reassignment NPD Authorized official
• Craft Behavioral Health Clinic

  dba Craft Laser Clinic

  • Technician
  • Jacksonville, FL
  • NPI 1184308108
  NPD (past)

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1205071719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566748",
            "telephone_number": "904-379-8748",
            "fax_number": "904-379-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY",
            "address_2": "SUITE 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566746",
            "telephone_number": "904-379-8748",
            "fax_number": "904-379-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASUL",
        "first_name": "IMTIAZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-12",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME-112178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd J Rasner, MD
• Gail Marie Raspanti, P.A.
• Pamela Raspberry
• Abigail Rassat, P.T.
• Loveena Rastogi, DDS
• Kayleigh E Ratashak
• Antoinette Ratcliff
• Aquanna Ratcliff
• Chris B Rathburn, MD
• Prachi Rathi, OTR/L

• Psychiatry Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.