Organization Active NPI

Infectious Disease Group, PA

  • Infectious Disease Physician
  • Pensacola, FL
National Provider Identifier
1235218405
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INFECTIOUS DISEASE GROUP, PA
Practice address
5120 Bayou Blvd Ste 11
Pensacola, FL 32503-2135
Phone
(850) 432-3692
Fax
(850) 332-6445
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Dr. Kristin Austin Jr.
Title
Office Manager
Phone
(850) 432-3692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X FL Primary

Addresses

Primary practice location

5120 Bayou Blvd Ste 11
Pensacola, FL 32503-2135

Mailing address

5120 Bayou Blvd Ste 11
Pensacola, FL 32503-2135
Phone (850) 432-3692

Other identifiers 2

IdentifierTypeStateIssuer
377030300MedicaidFL
529502140MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050727000335 FL Part B Supplier - Clinic/Group Practice 9537197074 Receives reassigned benefits from 3 practitioners
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Locations

1717 N E St
Ste 439
Pensacola, FL 32501
Phone (850) 432-3692

5120 Bayou Blvd
Ste 11
Pensacola, FL 32503
Phone (850) 432-3692

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1235218405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 BAYOU BLVD STE 11",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032135",
            "telephone_number": "850-432-3692",
            "fax_number": "850-432-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 BAYOU BLVD STE 11",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032135",
            "telephone_number": "850-432-3692",
            "fax_number": "850-332-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASE GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-432-3692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377030300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529502140",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.