Individual provider Active NPI

Bartholomew Ndife

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1407526411
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11015190 Issued in FL
Practice address
1255 Lila St
Jacksonville, FL 32208-3550
Phone
(904) 383-1001
Fax
(904) 383-1991
NPI assigned
Sep 20, 2021
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11015190 FL Primary

Addresses

Primary practice location

1255 Lila St
Jacksonville, FL 32208-3550

Mailing address

8274 Bayberry Rd
Jacksonville, FL 32256-7470

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211122002667 FL Practitioner - Nurse Practitioner 4587053012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida International Univ, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians

Practice addresses (Care Compare)

2377 Dunn Ave
Jacksonville, FL 32218-6983
Phone (904) 633-0700

450077 State Rd
Suite 12
Callahan, FL 32011-3863
Phone (904) 633-0560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11015190FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Nov 29, 2021 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Nov 29, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Nov 29, 2021 Accepting new patients
North Florida Primary Associates, LLC CurrentSince Mar 30, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Past Accepting new patients

Locations

450077 State Road 200
Ste 12
Callahan, FL 32011
Phone (904) 633-0560

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

12620 Beach Blvd
Ste 3
Jacksonville, FL 32246
Phone (904) 463-3771

12620 Beach Blvd
Ste 3155
Jacksonville, FL 32246

2377 Dunn Ave
Jacksonville, FL 32218
Phone (904) 633-0700

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

6885 Belfort Oaks Pl
Ste 230
Jacksonville, FL 32216
Phone (904) 222-6176

8274 Bayberry Rd
Jacksonville, FL 32256
Phone (904) 633-0800

Interoperability endpoints

  • Direct secure messaging: bndife162097@direct.shands.ufl.edu
  • FHIR API: https://fhir4.healow.com/fhir/r4/AIFEAD

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1407526411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8274 BAYBERRY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 LILA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322083550",
            "telephone_number": "904-383-1001",
            "fax_number": "904-383-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIFE",
        "first_name": "BARTHOLOMEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-20",
        "last_updated": "2023-03-02",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11015190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.