NPIMap

Individual provider Active NPI

Ario Rezaei, MD

  • Vascular & Interventional Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1417158452
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
ME106433 Issued in FL
Practice address
1800 Barrs St
Jacksonville, FL 32204-4704
Phone
(904) 388-2556
NPI assigned
May 29, 2007
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME106433 FL
Vascular & Interventional Radiology Physician 2085R0204X ME106433 FL Primary

Addresses

Primary practice location

1800 Barrs St
Jacksonville, FL 32204-4704

Mailing address

PO Box 161180
Altamonte Springs, FL 32716-1180
Phone (904) 388-6949

Other identifiers 3

IdentifierTypeStateIssuer
002355300MedicaidFL
148SNOtherFLBC BS OF FLORIDA
906393006AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100721000778 FL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8123173838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Michigan Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors McClow Clark and Berk PAGroup PAC ID 4587607577, 23 clinicians

Practice addresses (Care Compare)

1670 St Vincents Way
Middleburg, FL 32068-8447
Phone (904) 308-1219

1726 Jeremiah St
Middleburg, FL 32068-8471
Phone (904) 388-6949

1800 Barrs St
Jacksonville, FL 32204-4704
Phone (904) 308-7300

205 Trinity Way
Saint Johns, FL 32259-1155
Phone (904) 308-7300

2345 Forbes St
Jacksonville, FL 32204-4311
Phone (904) 381-9994

6138 Kennerly Rd
Jacksonville, FL 32216-4393
Phone (904) 733-7770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.44 of 100Reported as group
Quality
83.7
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME106433FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors McClow Clark & Berk PA Diagnostic Radiology CurrentSince Jul 19, 2010 Accepting new patients

Locations

10503 San Jose Blvd
Ste 100
Jacksonville, FL 32257
Phone (904) 710-3195

1800 Barrs St
Jacksonville, FL 32204
Phone (904) 387-4030

2345 Forbes St
Jacksonville, FL 32204
Phone (904) 381-9994

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

6488 103rd St
Jacksonville, FL 32210
Phone (904) 450-6810

3316 3rd St S
Ste 101
Jax Bch, FL 32250
Phone (904) 241-7772

1670 St Vincents Way
Middleburg, FL 32068
Phone (904) 308-1219

2001 County Road 210 W
Saint Johns, FL 32259
Phone (904) 450-6270

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1417158452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161180",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161180",
            "telephone_number": "904-388-6949",
            "fax_number": "904-388-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BARRS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044704",
            "telephone_number": "904-388-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAEI",
        "first_name": "ARIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME106433",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME106433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002355300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF FLORIDA",
            "identifier": "148SN",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "906393006A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.