Individual provider Active NPI

Fred H Lambrou Jr., M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Jacksonville, FL
National Provider Identifier
1437143666
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
ME53221 Issued in FL
Practice address
2 Shircliff Way Ste 715
Jacksonville, FL 32204-4759
Phone
(904) 388-8446
Fax
(904) 384-6261
NPI assigned
Sep 2, 2005
Reactivated
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME026143 GA
Ophthalmology Physician 207W00000X ME0053221 FL
Retina Specialist (Ophthalmology) Physician 207WX0107X ME53221 FL Primary

Addresses

Primary practice location

2 Shircliff Way Ste 715
Jacksonville, FL 32204-4759

Mailing address

2 Shircliff Way Ste 715
Jacksonville, FL 32204-4759
Phone (904) 388-8446

Other identifiers 3

IdentifierTypeStateIssuer
00394479AMedicaidGA
048036300MedicaidFL
05860OtherFLBCBS

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
I20090108000720 FL Practitioner - Ophthalmology 9234292897 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0053221FLMDOphthalmology Physician
ME026143GAMDOphthalmology Physician
ME53221FLMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jan 10, 2022 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc Ophthalmology CurrentSince Jan 10, 2022 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: flambrou@jrafl.intellechartdirect.net

Organizations & group practices 3

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1437143666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 715",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044759",
            "telephone_number": "904-388-8446",
            "fax_number": "904-384-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 715",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044759",
            "telephone_number": "904-388-8446",
            "fax_number": "904-384-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBROU",
        "first_name": "FRED",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2017-11-06",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "ME026143",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0053221",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME53221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00394479A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048036300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05860",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.