Individual provider Active NPI

Gary W Padilla-Maldonado, MD

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1396272902
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME143504 Issued in FL
Practice address
4500 San Pablo Rd S FL 32224
Jacksonville, FL 32224
Phone
(904) 953-2000
NPI assigned
May 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME143504 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S FL 32224
Jacksonville, FL 32224

Mailing address

4500 San Pablo Rd S FL 32224
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other practice location 1

550 Sergio Cuevas Busta
San Juan, PR
San Juan, PR 00936
Phone (787) 758-8383 ext. 8494

Other names 1

  • Gary W Padilla Maldonado Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gpadillamaldonado391621@ehrdirect.mayoclinicmsg.org

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
I20230623002237 FL Practitioner - Diagnostic Radiology 4789931379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1011 NE 58TH St
Unit 106
Oakland Park, FL 33334-4133
Phone (904) 399-5550

13001 Southern Blvd
Loxahatchee, FL 33470-9203
Phone (904) 399-5550

13695 US Hwy 1
Sebastian, FL 32958-3230
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2201 45TH St
West Palm Beach, FL 33407-2047
Phone (904) 399-5550

2801 N St Rd
Suite 7
Margate, FL 33063-5727
Phone (904) 399-5550

7201 N University Dr
Tamarac, FL 33321-2913
Phone (904) 399-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
74.85
Promoting interoperability
100
Improvement activities
40
Cost
72.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME143504FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2023 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2023 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients

Locations

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313
Phone (866) 747-5834

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: gpadillamaldonado391621@ehrdirect.mayoclinicmsg.org

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 4

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1396272902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S FL 32224",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S FL 32224",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Sergio Cuevas Busta",
            "address_2": "San Juan, PR",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00936",
            "country_code": "US",
            "telephone_number": "787-758-8383 x8494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADILLA-MALDONADO",
        "first_name": "GARY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME143504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gpadillamaldonado391621@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S Fl 32224",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "PADILLA MALDONADO",
            "middle_name": "W",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.