NPIMap

Individual provider Active NPI

Isaac M Kinman, D.O.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1265953954
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS15575 Issued in FL
Practice address
532 Riverside Ave Ste 103
Jacksonville, FL 32202-4914
Phone
(904) 353-5696
Fax
(904) 390-7483
NPI assigned
Jul 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS15575 FL Primary

Addresses

Primary practice location

532 Riverside Ave Ste 103
Jacksonville, FL 32202-4914

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092

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
I20190715000311 FL Practitioner - Family Practice 6507125911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern Univ College of Dental Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

124 E Ashley St
Jacksonville, FL 32202-3118
Phone (904) 353-5696

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists of Jacksonville CurrentSince Jun 15, 2019 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Baptist Primary Care Inc. Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients

Locations

124 E Ashley St
Jacksonville, FL 32202
Phone (904) 353-5696

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

532 Riverside Ave
Ste 103
Jacksonville, FL 32202
Phone (904) 353-5696

Interoperability endpoints

  • Direct secure messaging: isaac.kinman.2@14027.direct.athenahealth.com
  • Direct secure messaging: ikinman28212@baptisthealthsystemjacksonville.direct-ci.com

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 7

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1265953954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 RIVERSIDE AVE STE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024914",
            "telephone_number": "904-353-5696",
            "fax_number": "904-390-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINMAN",
        "first_name": "ISAAC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS15575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.