Individual provider Active NPI

Asma Najeeb Salahuddin, M.D.

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1366677262
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME113495 Issued in FL
Practice address
841 Prudential Dr
Suite 1130
Jacksonville, FL 32207-8329
Phone
(904) 633-4199
Fax
(904) 633-4188
NPI assigned
May 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X TRN13470 FL
Pediatrics Physician 208000000X ME113495 FL Primary

Addresses

Primary practice location

841 Prudential Dr
Suite 1130
Jacksonville, FL 32207-8329

Mailing address

841 Prudential Dr
Suite 1130
Jacksonville, FL 32207-8329
Phone (904) 633-4199

Other identifiers 3

IdentifierTypeStateIssuer
14L1TOtherFLBCBSFL
005949200MedicaidFL
003125691AMedicaidGA

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
I20120802000069 FL Practitioner - Pediatric Medicine 3678729910 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113495FLMDPediatrics Physician
TRN13470FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Feb 19, 2014 Accepting new patients
The Nemours Foundation CurrentSince Feb 19, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2012 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Pediatrics Current Accepting new patients
University of Florida Jacksonville Physicians Inc Pediatrics CurrentSince Jul 1, 2012 Accepting new patients
The Nemours Foundation Current Accepting new patients

Locations

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

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

841 Prudential Dr
Ste 1130
Jacksonville, FL 32207
Phone (904) 633-4180

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

Interoperability endpoints

  • Direct secure messaging: asalahuddin37555@direct.shands.ufl.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1366677262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR",
            "address_2": "SUITE 1130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078329",
            "telephone_number": "904-633-4199",
            "fax_number": "904-633-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR",
            "address_2": "SUITE 1130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078329",
            "telephone_number": "904-633-4199",
            "fax_number": "904-633-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAHUDDIN",
        "first_name": "ASMA",
        "middle_name": "NAJEEB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "TRN13470",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME113495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "14L1T",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005949200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125691A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.