Individual provider Active NPI

Carmen Liliana Isache, M.D.

  • Infectious Disease Physician
  • Jacksonville, FL
National Provider Identifier
1255657979
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME122625 Issued in FL
Practice address
515 W 6TH St
Jacksonville, FL 32206-4324
Phone
(904) 253-1040
Fax
(904) 253-1931
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME122625 FL
Infectious Disease Physician 207RI0200X ME122625 FL Primary

Addresses

Primary practice location

515 W 6TH St
Jacksonville, FL 32206-4324

Mailing address

653 W 8TH St # L14
Jacksonville, FL 32209-6511
Phone (904) 244-7514

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
I20150518002187 FL Practitioner - Internal Medicine 2365762127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-6700

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

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
ME122625FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Internal Medicine Current Accepting new patients
University of Florida Jacksonville Physicians Inc Internal Medicine CurrentSince Jun 22, 2015 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jun 22, 2015 Accepting new patients

Locations

653 W 8th St
#L14
Jacksonville, FL 32209

10475 Centurion Pkwy N
Ste 201
Jacksonville, FL 32256
Phone 90422333213118

515 W 6th St
Jacksonville, FL 32206
Phone (904) 253-1040

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

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1255657979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST # L14",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-7514",
            "fax_number": "904-244-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W 6TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064324",
            "telephone_number": "904-253-1040",
            "fax_number": "904-253-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISACHE",
        "first_name": "CARMEN LILIANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME122625",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME122625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.