Active NPI
Lisa A D'Amico, MD
- Emergency Medicine Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME89476
- Practice address
- 800 Prudential Dr
Emergency Resources Group
Jacksonville, FL 32207-8202 - Phone
- (904) 396-5682
- Fax
- (904) 346-0864
- NPI assigned
- May 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | ME89476 | FL | Primary |
Addresses
Primary practice location
800 Prudential Dr
Emergency Resources Group
Jacksonville, FL 32207-8202
Mailing address
820 Prudential Dr Ste 713
Jacksonville, FL 32207-8209
Phone (904) 396-5682
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44055 | Other | FL | BCBS |
| 269935400 | Medicaid | FL | |
| 970778487A | Medicaid | GA |
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 98
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physicians Inc | Emergency Medicine | Current | Accepting new patients |
| Emergency Physicians Inc | Emergency Medicine | Current | Accepting new patients |
Locations
1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000
1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000
800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000
820 Prudential Dr
Ste 713
Jacksonville, FL 32207
Phone (800) 936-5996
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Jacksonville, FL
- NPI 1285686675
-
- Emergency Medicine Physician
- Brunswick, GA
- NPI 1477001972
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278633600000",
"number": "1508824657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 PRUDENTIAL DR STE 713",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078209",
"telephone_number": "904-396-5682",
"fax_number": "904-346-0864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 PRUDENTIAL DR",
"address_2": "EMERGENCY RESOURCES GROUP",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078202",
"telephone_number": "904-396-5682",
"fax_number": "904-346-0864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AMICO",
"first_name": "LISA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2010-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME89476",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "44055",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "269935400",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "970778487A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.