NPIMap

Individual provider Active NPI

Ali Chahlavi, M.D.

  • Neurological Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1336198209
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME95578 Issued in FL
Practice address
4205 Belfort Rd
Joe Adams Building Suite 1100
Jacksonville, FL 32216-5876
Phone
(904) 296-3103
Fax
(904) 296-3106
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME95578 FL Primary

Addresses

Primary practice location

4205 Belfort Rd
Joe Adams Building Suite 1100
Jacksonville, FL 32216-5876

Mailing address

4205 Belfort Rd
Joe Adams Building Suite 1100
Jacksonville, FL 32216-1471
Phone (904) 296-3103

Other identifiers 1

IdentifierTypeStateIssuer
ME95578OtherFLMEDICAL LICENSE

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
I20060727000314 FL Practitioner - Neurosurgery 6507879111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Georgetown University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

4205 Belfort Rd
Jacksonville, FL 32216-1471
Phone (904) 308-7959

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion406
Laminectomy or laminotomy (partial removal of spine bones)184

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc Neurological Surgery CurrentSince Jul 1, 2008 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jul 1, 2008 Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

4205 Belfort Rd
Ste 1100
Jacksonville, FL 32216
Phone (904) 296-3103

Interoperability endpoints

  • Direct secure messaging: ali.chahlavi.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 11

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1336198209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD",
            "address_2": "JOE ADAMS BUILDING SUITE 1100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161471",
            "telephone_number": "904-296-3103",
            "fax_number": "904-296-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD",
            "address_2": "JOE ADAMS BUILDING SUITE 1100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165876",
            "telephone_number": "904-296-3103",
            "fax_number": "904-296-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAHLAVI",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME95578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL  LICENSE",
            "identifier": "ME95578",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.