Individual provider Active NPI

Carlene Annmarie Gentles, M.D.

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1538106927
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME95607 Issued in FL
Practice address
655 W 8TH St
Ufjp Radiology
Jacksonville, FL 32209-6511
Phone
(904) 244-4224
Fax
(904) 244-3382
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME95607 FL Primary

Addresses

Primary practice location

655 W 8TH St
Ufjp Radiology
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3660

Other identifiers 1

IdentifierTypeStateIssuer
492666414AMedicaidGA

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
I20091104000668 FL Practitioner - Diagnostic Radiology 8022156421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Viera Diagnostic Center LLCGroup PAC ID 1153304126, 2 clinicians

Practice addresses (Care Compare)

7000 Spyglass CT
Suite 260
Viera, FL 32940-8291
Phone (321) 254-7880

Merit-based Incentive Payment System (MIPS)

Final score
87 of 100Reported as group
Quality
74
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Viera Diagnostic Center LLC CurrentSince Sep 11, 2009 Accepting new patients
National Radiology Consultants, P.a. Diagnostic Radiology Past Accepting new patients

Locations

6609 N Wickham Rd
Ste 101
Melbourne, FL 32940
Phone (321) 254-7880

7000 Spyglass Ct
Ste 260
Viera, FL 32940
Phone (321) 254-7880

Networks

  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1538106927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3660",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP RADIOLOGY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4224",
            "fax_number": "904-244-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTLES",
        "first_name": "CARLENE",
        "middle_name": "ANNMARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME95607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "492666414A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.