Maria Mahmoodi, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME93514 Issued in FL

Practice address

2627 Riverside Ave
Jacksonville, FL 32204-4712

Phone

(904) 308-7372

Fax

(904) 308-2998

NPI assigned

May 25, 2006

Last updated

Jul 13, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

University of Colorado School of Medicine, Denver, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clay Primary and Family Care LLCGroup PAC ID 0840196176, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Clay Primary & Family Care LLC

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1730186792
  Medicare reassignment Care Compare group
• St Vincents Medical Center Inc

  dba St Vincents Family Medicine Center

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1427005131
  Medicare reassignment NPD
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1306892146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOODI",
        "first_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME93514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274210100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Mahboob, MMS, PA-C
• Inas Mahdi, PHARMD
• Kerry A Maher, M.D.
• Madison Maher, LCSW, QS
• Shelby Mahler, PT, DPT
• Omar Mahmoud, M.D.
• Saniyyah Itani Mahmoudi, ARNP
• Abusad Mahmud, DMD
• Clerissa C Mahon, APRN
• Katie S Mahon, PH.D.

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.