Individual provider Active NPI

Esther Noni Bit-Ivan, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Jacksonville, FL
National Provider Identifier
1265678015
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
125054795 Issued in IL
Practice address
800 Prudential Dr
Jacksonville, FL 32207
Phone
(912) 261-2669
Fax
(912) 261-0561
NPI assigned
Dec 29, 2008
Last updated
Jun 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 125054795 IL Primary

Addresses

Primary practice location

800 Prudential Dr
Jacksonville, FL 32207

Mailing address

203 Indigo Dr
Brunswick, GA 31525-6865
Phone (912) 261-2669

Other practice location 1

701 N 1st St
Memorial Medical Center, Department of Laboratory Medic
Springfield, IL 62781-0001
Phone (773) 837-5183

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
I20161213001607 FL Practitioner - Pathology 2062638885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (912) 261-2669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125054795ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Aug 16, 2016 Accepting new patients
Southeastern Pathology Associates PC Anatomic Pathology & Clinical Pathology PastSince Jul 1, 1999 Accepting new patients

Locations

1250 S 18th St
Fernandina Beach, FL 32034
Phone (904) 202-2087

801 Oak St
Green Cv Spgs, FL 32043
Phone (904) 215-7015

14550 Old St Augustine Rd
Jacksonville, FL 32258
Phone (904) 202-5010

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

1350 13th Ave S
Jax Bch, FL 32250
Phone (904) 247-2900

203 Indigo Dr
Brunswick, GA 31525
Phone (912) 279-1900

898 College St
Monticello, GA 31064
Phone (706) 468-0988

2810 N Oak St
Valdosta, GA 31602
Phone (229) 259-0019

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1265678015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 INDIGO DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315256865",
            "telephone_number": "912-261-2669",
            "fax_number": "912-261-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "912-261-2669",
            "fax_number": "912-261-0561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_2": "Memorial Medical Center, Department of Laboratory Medic",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627810001",
            "country_code": "US",
            "telephone_number": "773-837-5183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIT-IVAN",
        "first_name": "ESTHER",
        "middle_name": "NONI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-29",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125054795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.