NPIMap

Individual provider Active NPI

Mirna F Barakat, MD

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1417911645
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME75096 Issued in FL
Practice address
2119 Oak St
Jacksonville, FL 32204-4410
Phone
(904) 389-2707
Fax
(904) 389-7009
NPI assigned
Apr 14, 2006
Last updated
Oct 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME75096 FL Primary

Addresses

Primary practice location

2119 Oak St
Jacksonville, FL 32204-4410

Mailing address

2119 Oak St
Jacksonville, FL 32204-4410
Phone (904) 389-2707

Other identifiers 1

IdentifierTypeStateIssuer
271968100MedicaidFL

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
I20120113000112 FL Practitioner - Rheumatology 7618144767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Arthritis and Rheumatology Clinic PAGroup PAC ID 8921275041, 2 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

2119 Oak St
Jacksonville, FL 32204-4410
Phone (904) 389-2707

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME75096FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis & Rheumatology Clinic PA Specialist CurrentSince Apr 1, 2001 Accepting new patients

Locations

2119 Oak St
Jacksonville, FL 32204
Phone (904) 389-2300

Organizations & group practices 2

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 9

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1417911645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 OAK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044410",
            "telephone_number": "904-389-2707",
            "fax_number": "904-389-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 OAK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044410",
            "telephone_number": "904-389-2707",
            "fax_number": "904-389-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAKAT",
        "first_name": "MIRNA",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME75096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271968100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.