Individual provider Active NPI

John H. Isaacs Jr., MD

  • Otolaryngology Physician
  • Gainesville, FL
National Provider Identifier
1356300479
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME29004 Issued in FL
Practice address
1601 SW Archer Rd
Gainesville, FL 32608-3003
Phone
(352) 273-5199
Fax
(352) 392-6781
NPI assigned
Mar 18, 2006
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME29004 FL Primary

Addresses

Primary practice location

1601 SW Archer Rd
Gainesville, FL 32608-3003

Mailing address

PO Box 100264
Gainesville, FL 32610-0264
Phone (352) 273-5199

Other practice location 1

6201 W Newberry Rd
Gainesville, FL 32605-4305
Phone (352) 265-9465

Other identifiers 2

IdentifierTypeStateIssuer
102237300MedicaidFL
000219535CMedicaidGA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100222000660 FL Practitioner - Otolaryngology 5395889885 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29004FLMDDentist
ME29004FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 23, 1976 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 23, 1976 Accepting new patients

Locations

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

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": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1356300479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100264",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100264",
            "telephone_number": "352-273-5199",
            "fax_number": "352-392-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326083003",
            "telephone_number": "352-273-5199",
            "fax_number": "352-392-6781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6201 W Newberry Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326054305",
            "country_code": "US",
            "telephone_number": "352-265-9465",
            "fax_number": "352-265-9466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "JOHN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME29004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102237300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000219535C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.