Organization Active NPI

First Coast Endocrinology, P.a.

  • Internal Medicine Physician
  • St Augustine, FL
National Provider Identifier
1467722025
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0067870 Issued in FL
Legal business name
FIRST COAST ENDOCRINOLOGY, P.A.
Practice address
300 Health Park Blvd
Suite 3008
St Augustine, FL 32086-3707
Phone
(904) 810-2425
Fax
(904) 810-5321
NPI assigned
Jan 12, 2012
Last updated
Jun 4, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST COAST ENDOCRINOLOGY, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Mr. Robert Andrew Oesterle, M.D.NPI 1053524116
Title
Owner
Phone
(904) 810-2425

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0067870 FL Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME0067670 FL

Addresses

Primary practice location

300 Health Park Blvd
Suite 3008
St Augustine, FL 32086-3707

Mailing address

300 Health Park Blvd
Suite 3008
St Augustine, FL 32086-3707
Phone (904) 810-2425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120412000576 FL Part B Supplier - Clinic/Group Practice 4981865250 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Augustine, FL; St Augustine, FL

National Provider Directory

National Provider Directory
Part of
First Coast Endocrinology P

Locations

2530 US Highway 1 S
Saint Augustine, FL 32086
Phone (904) 810-2425

300 Health Park Blvd
Ste 3008
St Augustine, FL 32086
Phone (904) 810-2425

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1467722025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD",
            "address_2": "SUITE 3008",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863707",
            "telephone_number": "904-810-2425",
            "fax_number": "904-810-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD",
            "address_2": "SUITE 3008",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863707",
            "telephone_number": "904-810-2425",
            "fax_number": "904-810-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST ENDOCRINOLOGY, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST COAST ENDOCRINOLOGY, P.A.",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "OESTERLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-810-2425",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0067870",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME0067670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.