NPIMap

Individual provider Active NPI

Marie Crandall, MD, MPH

  • Surgical Critical Care Physician
  • Jacksonville, FL
National Provider Identifier
1568426245
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
125520 Issued in FL
Practice address
655 W. 8TH Street
Division of Acute Care Surgery
Jacksonville, FL 32209-5975
Phone
(904) 244-6631
NPI assigned
Apr 12, 2006
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 036-099830 IL
Surgical Critical Care Physician 2086S0102X 125520 FL Primary

Addresses

Primary practice location

655 W. 8TH Street
Division of Acute Care Surgery
Jacksonville, FL 32209-5975

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-6631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151105001297 FL Practitioner - Critical Care (Intensivists) 6800793233 Reassigns benefits to 1 organization
I20240506004684 OH Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6800793233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125520FLMDSurgical Critical Care Physician
036-099830ILMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Feb 28, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians Inc Surgical Critical Care CurrentSince Sep 14, 2015 Accepting new patients
The Metrohealth System Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Sep 14, 2015 Accepting new patients
The Metrohealth System CurrentSince Feb 28, 2024 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

Interoperability endpoints

  • Direct secure messaging: mcrandall273631@direct.metrohealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1568426245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-6631",
            "fax_number": "904-244-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W. 8TH STREET",
            "address_2": "DIVISION OF ACUTE CARE SURGERY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322095975",
            "telephone_number": "904-244-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036-099830",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "125520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.