Individual provider Active NPI

Anisleidy Carbo, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1467958322
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME150736 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Mar 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME150736 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other practice location 1

2041 Georgia Avenue NW Towers Building Suite 3200
Washington, DC 20060-0001
Phone (202) 865-7677

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address acarbo1445510@ehrdirect.mayoclinicmsg.org

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
I20210804000558 FL Practitioner - Family Practice 0648674234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

110 Southwood Lake Dr
Saint Augustine, FL 32086-7286
Phone (904) 794-2777

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

742 Marsh Landing Pkwy
Jacksonville, FL 32250-5850
Phone (904) 953-7005

Hospital & facility affiliations

  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
74.85
Promoting interoperability
100
Improvement activities
40
Cost
72.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME150736FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Jul 29, 2021 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 29, 2021 Accepting new patients
Howard University Family Medicine Past Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

Interoperability endpoints

  • Direct secure messaging: anisleidy.carbo.1@21075.direct.athenahealth.com

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 1

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": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1467958322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Avenue NW Towers Building Suite 3200",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200600001",
            "country_code": "US",
            "telephone_number": "202-865-7677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBO",
        "first_name": "ANISLEIDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-31",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME150736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acarbo1445510@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.