Individual provider Active NPI

Dina Mahmoud Mustafa Elantably, MD

  • Hematology & Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1487226460
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME167223 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Jul 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME167223 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

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address delantably2224124@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
I20240611003083 FL Practitioner - Hematology/Oncology 9931502341 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville Current Accepting new patients
The Metrohealth System Current Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2024 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2024 Accepting new patients

Locations

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

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

Interoperability endpoints

  • Direct secure messaging: delantably2224124@ehrdirect.mayoclinicmsg.org
  • Direct secure messaging: delantably207768@direct.metrohealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1487226460",
    "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": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELANTABLY",
        "first_name": "DINA",
        "middle_name": "MAHMOUD MUSTAFA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-11",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME167223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "delantably2224124@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.