First Coast Gastroenterology

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME90376 Issued in FL

Legal business name

FIRST COAST GASTROENTEROLOGY

Practice address

100 Whetstone PL
Suite 105
St Augustine, FL 32086-5773

Phone

(904) 829-9557

Fax

(904) 829-9125

NPI assigned

Jul 29, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Benoit C Pineau, MDNPI 1619173309

Title

Authorized Official

Phone

(904) 829-9557

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Ben C Pineau MD Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benoit C Pineau, MD

  • Gastroenterology Physician
  • St. Augustine, FL
  • NPI 1619173309
  NPD (past) Authorized official

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1528068624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL",
            "address_2": "SUITE 105",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865773",
            "telephone_number": "904-829-9557",
            "fax_number": "904-829-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PL",
            "address_2": "SUITE 105",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865773",
            "telephone_number": "904-829-9557",
            "fax_number": "904-829-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "PINEAU",
        "authorized_official_first_name": "BENOIT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "904-829-9557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME90376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00147263",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR - GROUP #",
            "identifier": "DC0902",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "44069",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269931100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ben C Pineau MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Gastroenterology Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.