Individual provider Active NPI

Daryoush Tavanaiepour, MD

  • Neurological Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1457560906
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME113574 Issued in FL
Practice address
580 W 8TH St
Tower1 8TH Floor
Jacksonville, FL 32209-6533
Phone
(904) 383-1022
Fax
(904) 244-9430
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 0101247523 VA
Student in an Organized Health Care Education/Training Program 390200000X 0116016383 VA
Neurological Surgery Physician 207T00000X ME113574 FL Primary

Addresses

Primary practice location

580 W 8TH St
Tower1 8TH Floor
Jacksonville, FL 32209-6533

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-3660

Other identifiers 3

IdentifierTypeStateIssuer
14KZ4OtherFLBCBSFL
003125606AMedicaidGA
005931400MedicaidFL

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
I20120807000778 FL Practitioner - Neurosurgery 7214121839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2003
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)

580 W 8TH St
Jacksonville, FL 32209-6533
Phone (904) 244-9390

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001
  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion51
Laminectomy or laminotomy (partial removal of spine bones)14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME113574FLMDNeurological Surgery Physician
0101247523VAMDNeurological Surgery Physician
0116016383VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
Integrity Spine and Orthopedics LLC Neurological Surgery CurrentSince Mar 3, 2024 Accepting new patients
University of Florida Jacksonville Physicians Inc Neurological Surgery CurrentSince Jul 16, 2012 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 16, 2012 Accepting new patients

Locations

580 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3960

580 W 8th St
Fl 1
Jacksonville, FL 32209
Phone (904) 383-1022

14785 Old St Augustine Rd
Ste 100
Jacksonville, FL 32258
Phone (904) 292-1808

15255 Max Leggett Pkwy
Ste 3600
Jacksonville, FL 32218
Phone (904) 383-1011

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

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

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

Interoperability endpoints

  • Direct secure messaging: dtavanaiepour72315@direct.shands.ufl.edu

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.

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1457560906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3660",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 8TH ST",
            "address_2": "TOWER1 8TH FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096533",
            "telephone_number": "904-383-1022",
            "fax_number": "904-244-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVANAIEPOUR",
        "first_name": "DARYOUSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101247523",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116016383",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME113574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "14KZ4",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125606A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005931400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.