Individual provider Active NPI

Lina Fouad, MD

  • Gynecology Physician
  • St Augustine, FL
National Provider Identifier
1285944462
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME120560 Issued in FL
Practice address
111 Nature Walk Pkwy Unit 107
St Augustine, FL 32092-3065
Phone
(904) 800-7613
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MT198292 PA
Gynecology Physician 207VG0400X ME120560 FL Primary

Addresses

Primary practice location

111 Nature Walk Pkwy Unit 107
St Augustine, FL 32092-3065

Mailing address

111 Nature Walk Pkwy Unit 107
St Augustine, FL 32092-3065

Other identifiers 1

IdentifierTypeStateIssuer
003181653AMedicaidGA

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
I20140905000569 FL Practitioner - Obstetrics/Gynecology 7719105626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT198292PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Obstetrics & Gynecology CurrentSince Oct 28, 2016 Accepting new patients
Vitalmd Group Holding LLC Obstetrics & Gynecology CurrentSince Oct 1, 2025 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 28, 2016 Accepting new patients
OBGYN Specialists of North Florida LLC Obstetrics & Gynecology Current Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

13241 Bartram Park Blvd
Unit 809
Jacksonville, FL 32258
Phone (904) 723-4827

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

111 Nature Walk Pkwy
Unit 107
St Augustine, FL 32092
Phone (904) 800-7613

Organizations & group practices 5

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": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751587200000",
    "number": "1285944462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NATURE WALK PKWY UNIT 107",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NATURE WALK PKWY UNIT 107",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923065",
            "telephone_number": "904-800-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUAD",
        "first_name": "LINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT198292",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME120560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181653A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.