Active NPI
Justin Anthony Ilagan, DO
- Nephrology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- OS21814
- Practice address
- 4500 San Pablo Rd S
Jacksonville, FL 32224-1865 - Phone
- (904) 953-2000
- NPI assigned
- Apr 9, 2021
- Last updated
- Jul 22, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25MB12169700 | NJ | |
| Nephrology Physician | 207RN0300X | OS21814 | FL | Primary |
Addresses
Primary practice location
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Mailing address
213 Berry Farm LN
Jacksonville, FL 32259-7211
Other practice location 1
1945 State Route 33
Neptune, NJ 07753-4859
Phone (732) 442-3700
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jilagan2527046@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Rowan University School of Osteopathic Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1945 State Hwy 33
Neptune, NJ 07753-4859
Phone (732) 775-5500
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS21814 | FL | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Plover Inpatient Services LLC | Internal Medicine | Current | Accepting new patients |
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Mayo Clinic Jacksonville | Current | Accepting new patients |
Locations
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815
1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100
1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194
1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333
425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1790772317
-
- Emergency Medicine Physician
- Montclair, NJ
- NPI 1134534688
Internal Medicine
-
dba Mayo Clinic Home Infusion Pharmacy
- Home Infusion Therapy Pharmacy
- Jacksonville, FL
- NPI 1003510116
-
dba Mayo Clinic Jacksonville advanced care at home
- Health Service Clinic/Center
- Jacksonville, FL
- NPI 1174143986
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1891782470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753142400000",
"number": "1609456037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 BERRY FARM LN",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322597211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
}
],
"practiceLocations": [
{
"address_1": "1945 State Route 33",
"address_purpose": "LOCATION",
"city": "Neptune",
"state": "NJ",
"postal_code": "077534859",
"country_code": "US",
"telephone_number": "732-442-3700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ILAGAN",
"first_name": "JUSTIN",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2025-07-22",
"certification_date": "2025-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MB12169700",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "OS21814",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jilagan2527046@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "4500 San Pablo Rd S",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322241865",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.