NPIMap

Individual provider Active NPI

Ali Ahmad Rawabdeh, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1205115599
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME130107 Issued in FL
Practice address
3625 University Blvd S
Jacksonville, FL 32216
Phone
(904) 702-6111
NPI assigned
Aug 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME130107 FL Primary

Addresses

Primary practice location

3625 University Blvd S
Jacksonville, FL 32216

Mailing address

13054 Aegean Dr
Jacksonville, FL 32246-5552
Phone (862) 242-9219

Other practice location 1

100 Franklin St
Apt A210
Morristown, NJ 07960-5443
Phone (862) 242-9219

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
I20171103001900 FL Practitioner - Internal Medicine 0244482008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4131 University Blvd S
Suite 6
Jacksonville, FL 32216-4346

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME130107FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Jul 26, 2017 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Jul 26, 2017 Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

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

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Interoperability endpoints

  • Direct secure messaging: arawabdeh581382@direct.shands.ufl.edu
  • FHIR API: https://fhir4.healow.com/fhir/r4/BDGHAD/Endpoint/BDGHAD

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1205115599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13054 AEGEAN DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322465552",
            "telephone_number": "862-242-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-702-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Franklin St",
            "address_2": "APT A210",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079605443",
            "country_code": "US",
            "telephone_number": "862-242-9219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAWABDEH",
        "first_name": "ALI",
        "middle_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME130107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.