Individual provider Active NPI

Amy Lynn Juraszek, MD

  • Pediatric Cardiology Physician
  • Jacksonville, FL
National Provider Identifier
1306837299
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME128997 Issued in FL
Practice address
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Phone
(904) 202-8550
Fax
(904) 393-7808
NPI assigned
Oct 31, 2005
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N3772 TX
Pediatric Cardiology Physician 2080P0202X N3772 TX
Pediatric Cardiology Physician 2080P0202X 77060 GA
Pediatric Cardiology Physician 2080P0202X ME128997 FL Primary

Addresses

Primary practice location

841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350

Mailing address

PO Box 44047
Jacksonville, FL 32231-4047
Phone (904) 202-8290

Other practice location 1

601 N Clyde Morris Blvd Ste A
Daytona Beach, FL 32114-2300
Phone (904) 202-8550

Other identifiers 1

IdentifierTypeStateIssuer
210141202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161111000759 FL Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 4587578968 Reassigns benefits to 1 organization
I20171207002861 GA Practitioner - Pediatric Medicine 4587578968 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77060GAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince Oct 1, 2017 Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology CurrentSince Jun 1, 2021 Accepting new patients
Baptist Specialty Physicians Inc Pediatric Cardiology PastSince Apr 24, 2022 Accepting new patients
Boston Childrens Heart Foundation Inc Pediatrics Past Accepting new patients

Locations

1219 Dunn Ave
Daytona Beach, FL 32114
Phone (386) 255-4568

601 N Clyde Morris Blvd
Ste A
Daytona Beach, FL 32114
Phone (386) 252-3985

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

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

836 Prudential Dr
Ste 802
Jacksonville, FL 32207
Phone (904) 202-8290

841 Prudential Dr
Ste 280
Jacksonville, FL 32207
Phone (904) 202-8290

2418 E Plaza Dr
Tallahassee, FL 32308
Phone (850) 629-4861

201 Lakeshore Pt
Ste B
Saint Marys, GA 31558
Phone (912) 729-6821

Interoperability endpoints

  • Direct secure messaging: ajuraszek225399@direct.shands.ufl.edu

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1306837299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44047",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314047",
            "telephone_number": "904-202-8290",
            "fax_number": "904-202-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 280",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078350",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Clyde Morris Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142300",
            "country_code": "US",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JURASZEK",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N3772",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "N3772",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "77060",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME128997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210141202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.