Individual provider Active NPI

Cherilyn Patrice Hanna Mahase, MBBS MD FACP

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1457896557
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME128822 Issued in FL
Practice address
6841 Blanding Blvd
Jacksonville, FL 32244-4418
Phone
(904) 862-2175
Fax
(904) 862-2330
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 128822 FL
Pediatrics Physician 208000000X 128822 FL
Internal Medicine Physician 207R00000X ME128822 FL Primary

Addresses

Primary practice location

6841 Blanding Blvd
Jacksonville, FL 32244-4418

Mailing address

6841 Blanding Blvd
Jacksonville, FL 32244-4418
Phone (904) 862-2175

Other practice location 1

7 Alexander Street
Nassau, New Providence SP60604
BS
Phone (242) 328-8716

Other names 1

  • Dr. Cherilyn Patrice Hanna Mahase Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181114003222 FL Practitioner - Internal Medicine 1951655794 Reassigns benefits to 5 organizations
I20230324002095 TN Practitioner - Internal Medicine 1951655794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upperline Healthcare PCGroup PAC ID 4385900653, 194 clinicians
Pascarella Hoover Finkelstein and Wagner DPM PAGroup PAC ID 9436235645, 102 clinicians

Practice addresses (Care Compare)

21 Hospital Dr
Suite 170a
Palm Coast, FL 32164-2454
Phone (386) 586-7373

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME128822FLMDInternal Medicine Physician
128822FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jan 13, 2020 Accepting new patients
Dedicated Physicians Group of Tennessee, PLLC CurrentSince May 1, 2023 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jan 13, 2020 Accepting new patients
Dedicated Physicians Group of Tennessee, PLLC CurrentSince May 1, 2023 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC PastSince Sep 1, 2020 Accepting new patients

Locations

6841 Blanding Blvd
Jacksonville, FL 32244
Phone (904) 862-2175

3614 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 419-7100

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

4613 S Orange Blossom Trl
Orlando, FL 32839
Phone (407) 232-9829

2724 N Hiawassee Rd
Ste 100
Orlando, FL 32818
Phone (407) 906-0082

1056 E Raines Rd
Memphis, TN 38116
Phone (901) 300-5777

2252 Lamar Ave
Memphis, TN 38114
Phone (901) 671-1800

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1457896557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6841 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322444418",
            "telephone_number": "904-862-2175",
            "fax_number": "904-862-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6841 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322444418",
            "telephone_number": "904-862-2175",
            "fax_number": "904-862-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Alexander Street",
            "address_purpose": "LOCATION",
            "city": "Nassau",
            "state": "New Providence",
            "postal_code": "SP60604",
            "country_code": "BS",
            "telephone_number": "242-328-8716",
            "fax_number": "242-328-8719",
            "country_name": "Bahamas",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "HANNA MAHASE",
        "first_name": "CHERILYN",
        "middle_name": "PATRICE",
        "name_prefix": "Dr.",
        "credential": "MBBS MD FACP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "128822",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "128822",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME128822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERILYN",
            "last_name": "HANNA MAHASE",
            "middle_name": "PATRICE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.