Annika Tabassum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TRN31414 Issued in FL

Practice address

2627 Riverside Ave
Jacksonville, FL 32204-4717

Phone

(904) 308-7372

NPI assigned

Jun 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carolina Family Care IncGroup PAC ID 4587557731, 81 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Charleston East Home health agency, Charleston, SC, CCN 427027
• Musc Medical Center Hospital, Charleston, SC, CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score

93.96 of 100Reported as group

Quality

89.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: atabassum451588@direct.musc.edu
• Direct secure messaging: annika.tabassum.1@8967.direct.athenahealth.com

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.

• Carolina Family Care, Inc

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1184655722
  Medicare reassignment Care Compare group NPD
• Carolina Family Care, Inc

  • Family Medicine Physician
  • Mt Pleasant, SC
  • NPI 1851723753
  NPD
• Carolina Family Care, Inc

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1750318101
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys SC, LLC

  • Home Health Agency
  • Charleston, SC
  • NPI 1447218748
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1073605879
  Care Compare affiliation
• Medical University Hospital Authority

  • Rehabilitation Hospital
  • Orangeburg, SC
  • NPI 1154020147
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1659435840
  Care Compare affiliation
• Medical University Hospital Authority

  • Psychiatric Hospital
  • Orangeburg, SC
  • NPI 1669171740
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1710683354
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1770280299
  Care Compare affiliation

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1497372320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044717",
            "telephone_number": "904-308-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044717",
            "telephone_number": "904-308-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABASSUM",
        "first_name": "ANNIKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN31414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Taaraf, PHARMD
• Fadel Taazieh, DPT, ATC
• Fereshteh P Taba, D.D.S
• Reza M. Taba, M.D.
• Hagop M Tabakian, MD
• Ali Tabatabai
• Jordyn Lea Taber, APRN
• Rabih Tabet, M.D.
• Jacquelyn Cuaresma Tabony, MA CCC/SLP
• Rosemary Tabor

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.