NPIMap

Individual provider Active NPI

Obaidullah Ahmed, MD

  • Family Medicine Physician
  • Yulee, FL
National Provider Identifier
1235190646
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME85133 Issued in FL
Practice address
851042 US Highway 17
Yulee, FL 32097-2845
Phone
(904) 225-3824
Fax
(904) 390-7440
NPI assigned
Mar 28, 2006
Last updated
May 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 044879 GA
Family Medicine Physician 207Q00000X ME85133 FL Primary

Addresses

Primary practice location

851042 US Highway 17
Yulee, FL 32097-2845

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032

Other identifiers 1

IdentifierTypeStateIssuer
P01693563OtherGARR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121212000253 FL Practitioner - Family Practice 2264684596 Reassigns benefits to 2 organizations
I20160720001035 GA Practitioner - Family Practice 2264684596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

1390 Boone Ave Ext
Kingsland, GA 31548-6515
Phone (419) 221-3717

851042 US Hwy 17
Yulee, FL 32097-2845
Phone (904) 225-3824

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18905OKMDAmbulatory Care Pharmacist
ME85133FLMDFamily Medicine Physician
044879GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Aug 22, 2016 Accepting new patients
Inpatient Consultants of Florida, Inc Current Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince Nov 26, 2012 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Aug 22, 2016 Accepting new patients
Inpatient Consultants of Florida, Inc CurrentSince Nov 26, 2012 Accepting new patients
Baptist Primary Care Inc Family Medicine Past Accepting new patients

Locations

45465 Fifth Ave
Callahan, FL 32011
Phone (904) 879-4544

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

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

2029 Professional Center Dr
Orange Park, FL 32073
Phone (904) 264-8621

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

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

462626 State Road 200
Ste 100
Yulee, FL 32097
Phone (904) 225-3824

851042 US Highway 17
Yulee, FL 32097
Phone (904) 225-3824

2060 Dan Proctor Dr
Ste 3100
Saint Marys, GA 31558
Phone (912) 466-7660

Interoperability endpoints

  • Direct secure messaging: oahmed28247@baptisthealthsystemjacksonville.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1235190646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851042 US HIGHWAY 17",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320972845",
            "telephone_number": "904-225-3824",
            "fax_number": "904-390-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "OBAIDULLAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "044879",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME85133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01693563",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yulee, FL

Sources for this page

Verify at the official NPI Registry.