NPIMap

Organization Active NPI

Doctors Inlet Pediatrics and Primary Care

Doing business as Doctors Inlet Internal Medicine, Spine and Pain

  • Internal Medicine Physician
  • Middleburg, FL
National Provider Identifier
1518328301
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DOCTORS INLET PEDIATRICS AND PRIMARY CARE
Doing business as
Doctors Inlet Internal Medicine, Spine and Pain
Practice address
430 College Dr Ste 100-102-104-106
Middleburg, FL 32068
Phone
(904) 298-1994
Fax
(904) 298-1973
NPI assigned
Mar 8, 2016
Last updated
Jul 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Authorized official

Name
Milind V Tilak, MDNPI 1316960735
Title
Owner
Phone
(904) 298-1994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X NU
Internal Medicine Physician 207R00000X NU Primary
Pediatrics Physician 208000000X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

430 College Dr Ste 100-102-104-106
Middleburg, FL 32068

Mailing address

430 College Drive
Suite 100/102
Middleburg, FL 32068-8531
Phone (904) 644-8669

Other names 1

  • Doctors Inlet Internal Medicine, Spine and Pain Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160721002783 FL DME Supplier - Physician - Family Practice 6901879170 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Middleburg, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1518328301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 COLLEGE DRIVE",
            "address_2": "SUITE 100/102",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688531",
            "telephone_number": "904-644-8669",
            "fax_number": "904-298-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 COLLEGE DR STE 100-102-104-106",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "32068",
            "telephone_number": "904-298-1994",
            "fax_number": "904-298-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS INLET PEDIATRICS AND PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "TILAK",
        "authorized_official_first_name": "MILIND",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-298-1994",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Inlet Internal Medicine, Spine and Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.