NPIMap

Individual provider Active NPI

Ali Kasraeian, MD

  • Urology Physician
  • Jacksonville, FL
National Provider Identifier
1336213271
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME 99247 Issued in FL
Practice address
6269 Beach Blvd
Suite 2
Jacksonville, FL 32216-2768
Phone
(904) 727-7955
Fax
(904) 727-7976
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME 99247 FL Primary

Addresses

Primary practice location

6269 Beach Blvd
Suite 2
Jacksonville, FL 32216-2768

Mailing address

6269 Beach Blvd
Suite 2
Jacksonville, FL 32216-2768
Phone (904) 727-7955

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
I20081124000582 FL Practitioner - Urology 0941360721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Florida College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

710 Lomax St
Suite 1
Jacksonville, FL 32204-4004
Phone (904) 483-2310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 99247FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Physician Specialists LLC Current Accepting new patients
Florida Physician Specialists LLC Urology CurrentSince Jan 1, 2013 Accepting new patients
Florida Physician Specialists LLC CurrentSince Jan 1, 2013 Accepting new patients

Locations

6269 Beach Blvd
Ste 2
Jacksonville, FL 32216
Phone (904) 727-7955

710 Lomax St
Jacksonville, FL 32204
Phone (904) 355-6584

Organizations & group practices 3

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 10

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1336213271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6269 BEACH BLVD",
            "address_2": "SUITE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162768",
            "telephone_number": "904-727-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6269 BEACH BLVD",
            "address_2": "SUITE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162768",
            "telephone_number": "904-727-7955",
            "fax_number": "904-727-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASRAEIAN",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME 99247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.