Individual provider Active NPI

Robert T. Bass Jr., MD

  • Gastroenterology Physician
  • Jacksonville Beach, FL
National Provider Identifier
1457328726
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME63940 Issued in FL
Practice address
570 Jacksonville Dr
Ufjp Beaches Liver and Digestive
Jacksonville Beach, FL 32250-3813
Phone
(904) 241-8448
Fax
(904) 244-3425
NPI assigned
Mar 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME63940 FL
Gastroenterology Physician 207RG0100X ME63940 FL Primary

Addresses

Primary practice location

570 Jacksonville Dr
Ufjp Beaches Liver and Digestive
Jacksonville Beach, FL 32250-3813

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008

Other identifiers 2

IdentifierTypeStateIssuer
3730948-00MedicaidFL
000553957BMedicaidGA

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
I20111220000428 FL Practitioner - Gastroenterology 0941476055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-6700

Hospital & facility affiliations

  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy135
Upper gastrointestinal (GI) endoscopy for acid reflux185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME63940FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Gastroenterology CurrentSince May 10, 1993 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince May 10, 1993 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Internal Medicine Current Accepting new patients

Locations

5191 First Coast Tech Pkwy
Jacksonville, FL 32224
Phone (904) 427-7399

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

570 Jacksonville Dr
Jacksonville Beach, FL 32250
Phone (904) 241-8448

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Interoperability endpoints

  • Direct secure messaging: rbass59273@direct.shands.ufl.edu

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.

Hospital & facility affiliations 4

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": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1457328726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 JACKSONVILLE DR",
            "address_2": "UFJP BEACHES LIVER AND DIGESTIVE",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503813",
            "telephone_number": "904-241-8448",
            "fax_number": "904-244-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "ROBERT",
        "middle_name": "T.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME63940",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME63940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3730948-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000553957B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.