Active NPI
Emilio P Supsupin Jr., M.D.
- Neuroradiology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- ME152526
- Practice address
- 655 W 8TH St
Jacksonville, FL 32209-6511 - Phone
- (904) 244-4202
- NPI assigned
- Jul 5, 2006
- Last updated
- Mar 9, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | N5422 | TX | |
| Neuroradiology Physician | 2085N0700X | ME152526 | 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) 244-4202
Other practice location 1
6411 Fannin St
Houston, TX 77030-1501
Phone (713) 500-7700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 182077101 | Medicaid | TX | |
| 182077102 | Other | TX | CSHCN |
| 8S7138 | Other | TX | BCBSTX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000
4555 Emerson Expressway
Suite 120
Jacksonville, FL 32207-4958
Phone (904) 383-1036
4555 Emerson St
Jacksonville, FL 32207-4958
5191 1St Coast Tech Pkwy
Jacksonville, FL 32224-0609
Phone (904) 427-6991
5420 W Loop S
Suite 2400
Bellaire, TX 77401-2107
Phone (713) 486-3550
6410 Fannin St
Houston, TX 77030-3005
6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093
6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700
653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680
655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218
6700 W Loop S
Bellaire, TX 77401-4122
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.11 of 100
- Quality
- 69.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.63
Merit-based Incentive Payment System (MIPS)
- Final score
- 59.59 of 100
- Quality
- 59.93
- Promoting interoperability
- 0
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME152526 | FL | MD | Neuroradiology Physician |
| N5422 | TX | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians, Inc. | Diagnostic Radiology | Current | Accepting new patients |
| Ut Physicians | Diagnostic Radiology | Current | Accepting new patients |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians Inc | Neuroradiology | Current | Accepting new patients |
| Ut Physicians | Current | Accepting new patients | |
| Ut Imaging - Houston LLP | Diagnostic Radiology | Past | Accepting new patients |
Locations
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
6700 West Loop S
Bellaire, TX 77401
Phone (713) 662-9729
6431 Fannin St
#2130B
Houston, TX 77030
Phone (713) 500-7631
6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200
6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714
5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000
Interoperability endpoints
- esupsupin547307@direct.shands.ufl.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
Diagnostic Radiology
-
- Diagnostic Radiology Physician
- Jacksonville, FL
- NPI 1326208695
Neuroradiology
-
dba UF Health Imaging Center-Baymeadows
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
-
- Diagnostic Radiology Physician
- Bellaire, TX
- NPI 1073562682
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Urgent Care Clinic/Center
- Jacksonville, FL
- NPI 1144962408
Hospital
-
dba Shands Jacksonville
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1821186313
-
dba Mhhs Hermann Outpatient Imaging Center
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Houston, TX
- NPI 1437189115
Hospital
-
dba Memorial Hermann Hospital
- General Acute Care Hospital
- Houston, TX
- NPI 1982666111
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741478400000",
"number": "1225069800",
"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": "904-244-4202"
},
{
"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": "904-244-4202"
}
],
"practiceLocations": [
{
"address_1": "6411 Fannin St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770301501",
"country_code": "US",
"telephone_number": "713-500-7700",
"fax_number": "713-500-7639",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUPSUPIN",
"first_name": "EMILIO",
"middle_name": "P",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2025-03-09",
"certification_date": "2025-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "N5422",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "FL",
"license": "ME152526",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "182077101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN",
"identifier": "182077102",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX",
"identifier": "8S7138",
"state": "TX"
}
],
"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 Mar 9, 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.