Individual provider Active NPI

Mobeen Hasan Rathore, M.D.

  • Pediatric Infectious Diseases Physician
  • Jacksonville, FL
National Provider Identifier
1245299320
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
ME60401 Issued in FL
Practice address
655 W 8TH St
Ufjp Pediatric Infectious Diseases
Jacksonville, FL 32209-6511
Phone
(904) 244-8350
Fax
(904) 244-3896
NPI assigned
Mar 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME60401 FL
Pediatric Infectious Diseases Physician 2080P0208X ME60401 FL Primary

Addresses

Primary practice location

655 W 8TH St
Ufjp Pediatric Infectious Diseases
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008

Other identifiers 3

IdentifierTypeStateIssuer
370017074OtherFLRAILROAD MEDICARE
000468069CMedicaidGA
0550540-00MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040714000951 FL Practitioner - Infectious DiseasePractitioner - Pediatric Medicine 8628057627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
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

LicenseStateTypeSpecialty
ME60401FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince Aug 1, 2000 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 1, 2000 Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

655 W 8th St
Fl 3
Jacksonville, FL 32209
Phone (904) 244-2120

Interoperability endpoints

  • Direct secure messaging: mrathore59457@direct.shands.ufl.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1245299320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP PEDIATRIC INFECTIOUS DISEASES",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-8350",
            "fax_number": "904-244-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHORE",
        "first_name": "MOBEEN",
        "middle_name": "HASAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-19",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME60401",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "FL",
            "license": "ME60401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "370017074",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000468069C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0550540-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.