Individual provider Active NPI

Pouya Shooliz, M.D.

  • Neurology Physician
  • Jacksonville, FL
National Provider Identifier
1508228529
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME143378 Issued in FL
Practice address
1370 13TH Ave S Ste 215
Jacksonville, FL 32250-3206
Phone
(904) 249-1041
Fax
(904) 249-9764
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME143378 FL Primary

Addresses

Primary practice location

1370 13TH Ave S Ste 215
Jacksonville, FL 32250-3206

Mailing address

PO Box 41113
Jacksonville, FL 32203-1113
Phone (904) 376-4400

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
I20200714000198 FL Practitioner - Neurology 2062708043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Neurology IncGroup PAC ID 0345366704, 47 clinicians

Practice addresses (Care Compare)

1370 13TH Ave S
Suite 215
Jacksonville Beach, FL 32250-3230
Phone (904) 249-1041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.46 of 100Reported as group
Quality
75.65
Promoting interoperability
100
Improvement activities
40
Cost
80.06

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Neurology Inc Neurology CurrentSince Jul 30, 2020 Accepting new patients

Locations

1370 13th Ave S
Ste 215
Jax Bch, FL 32250
Phone (904) 249-1041

Interoperability endpoints

  • Direct secure messaging: pshooliz28428@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 1

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 4

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1508228529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41113",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322031113",
            "telephone_number": "904-376-4400",
            "fax_number": "904-391-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 13TH AVE S STE 215",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322503206",
            "telephone_number": "904-249-1041",
            "fax_number": "904-249-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOLIZ",
        "first_name": "POUYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME143378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.