Individual provider Active NPI

Ashraf Gayed Andrawis, MD

  • Pain Medicine Physician
  • Orange Park, FL
National Provider Identifier
1568445666
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
ME90040 Issued in FL
Practice address
1543 Kingsley Ave
BLDG 3
Orange Park, FL 32073-4535
Phone
(904) 264-0770
Fax
(904) 264-0670
NPI assigned
Nov 22, 2005
Last updated
Apr 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X ME90040 FL Primary

Addresses

Primary practice location

1543 Kingsley Ave
BLDG 3
Orange Park, FL 32073-4535

Mailing address

1543 Kingsley Ave
BLDG 3
Orange Park, FL 32073-4535
Phone (904) 264-0770

Other identifiers 1

IdentifierTypeStateIssuer
16753ZOtherFLMEDICARE GROUP NUMBER

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
I20050910000155 FL Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 8527047208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Spine and Pain Center PAGroup PAC ID 3274613013, 5 clinicians

Practice addresses (Care Compare)

1045 Riverside Ave
Suite 110
Jacksonville, FL 32204-4148
Phone (904) 264-0770

1543 Kingsley Ave
Suite 3
Orange Park, FL 32073-4583
Phone (904) 264-0770

1548 S Water St
Starke, FL 32091-4511
Phone (904) 264-0770

159 N 3Rd St
Macclenny, FL 32063-2103
Phone (904) 264-0770

4131 University Blvd S
Suite 11
Jacksonville, FL 32216-4346
Phone (904) 264-0770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Spine & Pain Center PA Pain Medicine CurrentSince Nov 1, 2007 Accepting new patients
Premier Assisted Living Facility, LLC Current Accepting new patients
Affordable Health Center, Inc Past Accepting new patients

Locations

1045 Riverside Ave
Ste 110
Jacksonville, FL 32204
Phone (904) 264-0770

4131 University Blvd S
Ste 11
Jacksonville, FL 32216
Phone (904) 636-7755

159 N 3rd St
Macclenny, FL 32063
Phone (904) 259-7815

1543 Kingsley Ave
Ste 3
Orange Park, FL 32073
Phone (904) 264-0770

554 Kingsley Ave
#5
Orange Park, FL 32073
Phone (904) 264-0770

1548B S Water St
Starke, FL 32091
Phone (352) 346-3127

Organizations & group practices 3

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 5

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1568445666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "BLDG 3",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-264-0770",
            "fax_number": "904-264-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "BLDG 3",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-264-0770",
            "fax_number": "904-264-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRAWIS",
        "first_name": "ASHRAF",
        "middle_name": "GAYED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME90040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "16753Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.