NPIMap

Organization Active NPI

Baptist MD Anderson Cancer Physicians Inc

Doing business as Baptist MD Anderson Cancer Physicians

  • Hematology & Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1538593124
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
BAPTIST MD ANDERSON CANCER PHYSICIANS INC
Doing business as
Baptist MD Anderson Cancer Physicians
Practice address
1235 San Marco Blvd
Suite 2
Jacksonville, FL 32207-8554
Phone
(904) 202-7300
Fax
(904) 202-7377
NPI assigned
Aug 30, 2013
Last updated
Apr 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Authorized official

Name
Leeann Mengel
Title
Vice President
Phone
(904) 202-7300

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X FL
Hematology & Oncology Physician 207RH0003X FL Primary
Pulmonary Disease Physician 207RP1001X FL
Medical Oncology Physician 207RX0202X FL
Gynecologic Oncology Physician 207VX0201X FL
Orthopaedic Surgery Physician 207X00000X NU
Otolaryngology Physician 207Y00000X NU
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X NU
Neurology Physician 2084N0400X FL
Radiation Oncology Physician 2085R0001X FL
Surgical Oncology Physician 2086X0206X FL
Urology Physician 208800000X FL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X FL

Addresses

Primary practice location

1235 San Marco Blvd
Suite 2
Jacksonville, FL 32207-8554

Mailing address

PO Box 746654
Atlanta, GA 30374-6654
Phone (904) 202-2092

Other identifiers 3

IdentifierTypeStateIssuer
003149978AMedicaidGA
DU3570OtherFLRAILROAD MEDICARE
0099422-00MedicaidFL

Other names 1

  • Baptist MD Anderson Cancer Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131217000276 FL Part B Supplier - Clinic/Group Practice 5991932063 Receives reassigned benefits from 147 practitioners
Practice locations: Jacksonville Beach, FL; Jacksonville, FL; Fleming Island, FL

National Provider Directory

National Provider Directory

Locations

1235 San Marco Blvd
Fl 4
Jacksonville, FL 32207

1235 San Marco Blvd
Ste 2
Jacksonville, FL 32207

1235 San Marco Blvd
Ste 400
Jacksonville, FL 32207

1301 Palm Ave
Ste 101
Jacksonville, FL 32207

1301 Palm Ave
Ste 600
Jacksonville, FL 32207

1301 Palm Ave
Ste 700
Jacksonville, FL 32207

1325 San Marco Blvd
Fl 5
Jacksonville, FL 32207

836 Prudential Dr
Ste 6
Jacksonville, FL 32207

Practitioners & affiliated clinicians

Practitioners 157

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 157

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1538593124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746654",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746654",
            "telephone_number": "904-202-2092",
            "fax_number": "904-393-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SAN MARCO BLVD",
            "address_2": "SUITE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078554",
            "telephone_number": "904-202-7300",
            "fax_number": "904-202-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MD ANDERSON CANCER PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "MENGEL",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "904-202-7300"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149978A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DU3570",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099422-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist MD Anderson Cancer Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 10, 2023; 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.