Individual provider Active NPI

Mohammed Noman Mona, M.D.

  • Urology Physician
  • Jacksonville, FL
National Provider Identifier
1427075399
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME 0027743 Issued in FL
Practice address
3599 University Blvd S
Suite 905
Jacksonville, FL 32216-4252
Phone
(904) 355-6583
Fax
(904) 355-0223
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME 0027743 FL Primary

Addresses

Primary practice location

3599 University Blvd S
Suite 905
Jacksonville, FL 32216-4252

Mailing address

710 Lomax St
Jacksonville, FL 32204-4004
Phone (904) 355-6583

Other identifiers 2

IdentifierTypeStateIssuer
4368281OtherAETNA
15409OtherFLBLUE CROSS BLUE SHIELD

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
I20100506001051 FL Practitioner - Urology 5395788517 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 0027743FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Physician Specialists LLC Urology CurrentSince Jan 1, 2013 Accepting new patients
Florida Physician Specialists LLC CurrentSince Jan 1, 2013 Accepting new patients
Florida Physician Specialists LLC Current Accepting new patients
McIver Urological Clinic Urology Current Accepting new patients

Locations

710 Lomax St
Jacksonville, FL 32204
Phone (904) 355-6584

3599 University Blvd S
Ste 905
Jacksonville, FL 32216
Phone (904) 396-4143

Interoperability endpoints

  • Direct secure messaging: mohammedmona@miuc.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1427075399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 LOMAX ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044004",
            "telephone_number": "904-355-6583",
            "fax_number": "904-355-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "SUITE 905",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-355-6583",
            "fax_number": "904-355-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONA",
        "first_name": "MOHAMMED",
        "middle_name": "NOMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME 0027743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4368281",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15409",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.