NPIMap

Individual provider Active NPI

Ricardo F Izurieta, M.D.

  • Pulmonary Disease Physician
  • Jacksonville, FL
National Provider Identifier
1275559098
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME80907 Issued in FL
Practice address
2 Shircliff Way
Suite 120
Jacksonville, FL 32204-4753
Phone
(904) 619-2006
Fax
(904) 619-2624
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME80907 FL
Pulmonary Disease Physician 207RP1001X ME80907 FL Primary

Addresses

Primary practice location

2 Shircliff Way
Suite 120
Jacksonville, FL 32204-4753

Mailing address

1893 Kingsley Ave
Ste C
Orange Park, FL 32073-4491
Phone (904) 276-2044

Other identifiers 2

IdentifierTypeStateIssuer
262071500MedicaidFL
35810YOtherFLMEDICARE PTAN

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
I20090626000565 FL Practitioner - Pulmonary Disease 0547311870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

2 Shircliff Way
Depaul Building Suite 435
Jacksonville, FL 32204-4753
Phone (904) 308-6900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME80907FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Dec 1, 2013 Accepting new patients
St Vincents Ambulatory Care Inc Pulmonary Disease CurrentSince Dec 1, 2013 Accepting new patients

Locations

1699 S 14th St
Ste 9
Fernandina Beach, FL 32034
Phone (904) 206-5000

2 Shircliff Way
Ste 120
Jacksonville, FL 32204
Phone (904) 619-2006

425 N Lee St
Ste 202
Jacksonville, FL 32204
Phone (904) 366-3736

425 N Lee St
Ste 101
Jacksonville, FL 32204
Phone (904) 358-9587

4203 Belfort Rd
Ste 108
Jacksonville, FL 32216
Phone (904) 450-6460

2 Shircliff Way
Ste 435
Jacksonville, FL 32204
Phone (904) 308-6900

3 Shircliff Way
Ste 625
Jacksonville, FL 32204
Phone (904) 308-6900

1658 St Vincents Way
Ste 210
Middleburg, FL 32068
Phone (904) 214-8161

1893 Kingsley Ave
Ste C
Orange Park, FL 32073
Phone (904) 375-8850

Interoperability endpoints

  • Direct secure messaging: ricardo.izurieta.1@8967.direct.athenahealth.com

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 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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1275559098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 KINGSLEY AVE",
            "address_2": "STE C",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734491",
            "telephone_number": "904-276-2044",
            "fax_number": "904-276-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "SUITE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044753",
            "telephone_number": "904-619-2006",
            "fax_number": "904-619-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZURIETA",
        "first_name": "RICARDO",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME80907",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME80907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262071500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "35810Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.