Vadim Lev Madfis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME82655 Issued in FL

Practice address

6320 Saint Augustine Rd
Unit 12
Jacksonville, FL 32217-2813

Phone

(904) 737-6200

Fax

(904) 737-6001

NPI assigned

Oct 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

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

Internal Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Internal Medicine Associates of Jacksonville P a

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1184614166
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1245229277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 SAINT AUGUSTINE RD",
            "address_2": "UNIT 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172800",
            "telephone_number": "904-737-6200",
            "fax_number": "904-737-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 SAINT AUGUSTINE RD",
            "address_2": "UNIT 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172813",
            "telephone_number": "904-737-6200",
            "fax_number": "904-737-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADFIS",
        "first_name": "VADIM",
        "middle_name": "LEV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME82655",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME82655",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110236096",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "06964",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264616100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "105540",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5866568",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Jeanne Maddox
• Supradeep Shree Venkata Madduri
• Colin Mader, DPT
• Jenna Mader
• Courtney L Madera, PT DPT
• Harry Madhanagopal, D.O.
• Colleen Madison
• Jade Madison
• Trenton R Madison, MD
• Michelle Susan Madjar, NP

• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.