Active NPI
Marie Gay C Navasero, MD
- Internal Medicine Physician
- Jacksonville, FL
National Provider Identifier
1306817713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 11269
- Practice address
- 1833 Boulevard
Jacksonville, FL 32206-4382 - Phone
- (904) 232-2751
- Fax
- (904) 301-2503
- NPI assigned
- Feb 1, 2006
- Last updated
- Sep 4, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 11269 | NV | Primary |
Addresses
Primary practice location
1833 Boulevard
Jacksonville, FL 32206-4382
Mailing address
1833 Boulevard
Jacksonville, FL 32206-4382
Phone (904) 232-2751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100505704 | Medicaid | NV |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141219001578 | FL | Order and Referring Only - Internal Medicine | 0749241529 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11269 | NV | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delco Health Clinic | Past | Accepting new patients | |
| Linda L. Johnson MD, LTD | Past | Accepting new patients |
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.
-
- General Practice Physician
- Delco, NC
- NPI 1013174663
-
dba SMA Convenient Care
- Adult Medicine Physician
- Henderson, NV
- NPI 1376838110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346716800000",
"number": "1306817713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1833 BOULEVARD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322064382",
"telephone_number": "904-232-2751",
"fax_number": "904-301-2503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1833 BOULEVARD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322064382",
"telephone_number": "904-232-2751",
"fax_number": "904-301-2503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAVASERO",
"first_name": "MARIE",
"middle_name": "GAY C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-01",
"last_updated": "2012-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NV",
"license": "11269",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100505704",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.