Individual provider Active NPI

Rafael Apontelopez, M.D.

  • Vascular & Interventional Radiology Physician
  • St Augustine, FL
National Provider Identifier
1265400428
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
ME57512 Issued in FL
Practice address
400 Health Park Blvd
Attn: Radiology Department
St Augustine, FL 32086-5784
Phone
(904) 819-4398
Fax
(904) 819-4976
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME57512 FL
Vascular & Interventional Radiology Physician 2085R0204X ME57512 FL Primary

Addresses

Primary practice location

400 Health Park Blvd
Attn: Radiology Department
St Augustine, FL 32086-5784

Mailing address

400 Health Park Blvd
Attn: Radiology Department
St Augustine, FL 32086-5784
Phone (904) 819-4398

Other identifiers 1

IdentifierTypeStateIssuer
052791200MedicaidFL

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
I20050810000561 FL Practitioner - Diagnostic Radiology 6901835909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME57512FLMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Nov 26, 2024 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Aug 8, 2023 Accepting new patients
Mercy Medical Development Inc Diagnostic Radiology Past Accepting new patients

Locations

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

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1265400428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "address_2": "ATTN: RADIOLOGY DEPARTMENT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-819-4398",
            "fax_number": "904-819-4976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "address_2": "ATTN: RADIOLOGY DEPARTMENT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-819-4398",
            "fax_number": "904-819-4976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APONTELOPEZ",
        "first_name": "RAFAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME57512",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME57512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052791200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.