NPIMap

Individual provider Active NPI

Radu Jacob, MD

  • Nephrology Physician
  • Coral Springs, FL
National Provider Identifier
1265462873
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME89216 Issued in FL
Practice address
8130 Royal Palm Blvd
Suite 102
Coral Springs, FL 33065-5703
Phone
(954) 345-4333
Fax
(954) 345-4334
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME89216 FL Primary

Addresses

Primary practice location

8130 Royal Palm Blvd
Suite 102
Coral Springs, FL 33065-5703

Mailing address

8130 Royal Palm Blvd
Suite 102
Coral Springs, FL 33065-5703
Phone (954) 345-4333

Other identifiers 1

IdentifierTypeStateIssuer
276603500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524000596 FL Practitioner - Nephrology 0042201428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

722 Riverside Dr
Coral Springs, FL 33071-7008
Phone (954) 345-4333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
82.12
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Jul 1, 2020 Accepting new patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Jul 1, 2020 Accepting new patients
All Specialty Care PA Past Accepting new patients
Mattoo & Bhat Medical Associates, P.C. Past Accepting new patients

Locations

722 Riverside Dr
Coral Springs, FL 33071
Phone (954) 345-4333

700 Riverside Dr
Coral Springs, FL 33071
Phone (954) 753-7870

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

8251 W Broward Blvd
Ste 100
Plantation, FL 33324
Phone (954) 908-1024

350 NW 84th Ave
Ste 200
Plantation, FL 33324
Phone (954) 424-4321

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: radu.jacob.1@15644.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 6

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1265462873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8130 ROYAL PALM BLVD",
            "address_2": "SUITE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655703",
            "telephone_number": "954-345-4333",
            "fax_number": "954-345-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 ROYAL PALM BLVD",
            "address_2": "SUITE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655703",
            "telephone_number": "954-345-4333",
            "fax_number": "954-345-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "RADU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME89216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276603500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.