Individual provider Active NPI

Paul Anthony Friedlin, OT,CHT

  • Hand Occupational Therapist
  • Jacksonville Beach, FL
National Provider Identifier
1417137266
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT4237 Issued in FL
Practice address
1577 Roberts Dr Ste 320
Jacksonville Beach, FL 32250-3266
Phone
(904) 247-3324
Fax
(904) 247-3926
NPI assigned
Nov 9, 2007
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT4237 FL
Hand Occupational Therapist 225XH1200X OT4237 FL Primary

Addresses

Primary practice location

1577 Roberts Dr Ste 320
Jacksonville Beach, FL 32250-3266

Mailing address

PO Box 117345
Atlanta, GA 30368-7345
Phone (904) 346-3465

Other practice location 1

14546 Old Saint Augustine Rd
Ste 405
Jacksonville, FL 32258-5468
Phone (904) 318-8818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060407000124 FL Practitioner - Occupational Therapist in Private Practice 8820006158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Orthopaedic Institute IncGroup PAC ID 5193625499, 60 clinicians

Practice addresses (Care Compare)

1577 Roberts Dr
Suite 320
Jacksonville Beach, FL 32250-3266
Phone (904) 247-3324

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Improvement activities
40
Cost
74.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT4237FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Orthopaedic Institute Inc Occupational Therapist CurrentSince Jul 30, 2020 Accepting new patients
Coastal Hand Therapy and Rehabilitation Inc PastSince Dec 31, 2005 Accepting new patients
Jacksonville Orthopaedic Institute Inc Occupational Therapist Past Accepting new patients
Jacksonville Orthopaedic Institute Inc Occupational Therapist PastSince Jul 30, 2020 Accepting new patients
Jacksonville Orthopaedic Institute Inc Occupational Therapist PastSince Jul 30, 2020 Accepting new patients

Locations

1348 S 18th St
Ste 320A
Fernandina Beach, FL 32034
Phone (904) 557-9021

1325 San Marco Blvd
Ste 200
Jacksonville, FL 32207
Phone (904) 346-3465

1577 Roberts Dr
Ste 320
Jacksonville Beach, FL 32250
Phone (904) 247-3324

203 Fort Wade Rd
Unit 130
Ponte Vedra, FL 32081
Phone (904) 686-3111

Organizations & group practices 5

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": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1417137266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117345",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687345",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 ROBERTS DR STE 320",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503266",
            "telephone_number": "904-247-3324",
            "fax_number": "904-247-3926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14546 Old Saint Augustine Rd",
            "address_2": "STE 405",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322585468",
            "country_code": "US",
            "telephone_number": "904-318-8818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIEDLIN",
        "first_name": "PAUL",
        "middle_name": "ANTHONY",
        "credential": "OT,CHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-09",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT4237",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "FL",
            "license": "OT4237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.