NPIMap

Organization Active NPI

North Florida Surgeons, PA

  • Orthopaedic Surgery Physician
  • Crestview, FL
National Provider Identifier
1497532212
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NORTH FLORIDA SURGEONS, PA
Practice address
120 E Redstone Ave Ste B
Crestview, FL 32539-5370
Phone
(850) 398-8600
Fax
(850) 331-2213
NPI assigned
Sep 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
John P. Berlin
Title
Ceo
Phone
(904) 396-1725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

120 E Redstone Ave Ste B
Crestview, FL 32539-5370

Mailing address

11945 San Jose Blvd Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725

Other names 1

  • North Florida Surgeons Bluewater Orthopedics, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250421002136 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2769381391 Practice locations: Crestview, FL

National Provider Directory

National Provider Directory
Tax ID family
North Flordia Surgeons38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1497532212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11945 SAN JOSE BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231627",
            "telephone_number": "904-396-1725",
            "fax_number": "904-396-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E REDSTONE AVE STE B",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395370",
            "telephone_number": "850-398-8600",
            "fax_number": "850-331-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA SURGEONS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "BERLIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-396-1725"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Florida Surgeons Bluewater Orthopedics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.