Individual provider Active NPI

Marija Glodevic Kantarevic, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1609649235
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11033264 Issued in FL
Practice address
7751 Baymeadows Rd E Ste 205
Jacksonville, FL 32256-5836
Phone
(904) 239-2132
NPI assigned
Nov 6, 2023
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9316148 FL
Family Nurse Practitioner 363LF0000X 11033264 FL Primary

Addresses

Primary practice location

7751 Baymeadows Rd E Ste 205
Jacksonville, FL 32256-5836

Mailing address

1936 Hollington Dr
Jacksonville, FL 32246-8459
Phone (904) 673-8091

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718001295 FL Practitioner - Nurse Practitioner 9739625468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7751 Baymeadows Rd E
205 Uf Health Oncology Baymeadows
Jacksonville, FL 32256-5836
Phone (904) 427-1050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9316148FLMDRegistered Nurse
11033264FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC Current Accepting new patients
Shands Jacksonville Medical Center Inc CurrentSince Jul 18, 2024 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince Jun 24, 2024 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince Jun 24, 2024 Accepting new patients
Shands Jacksonville Medical Center Inc CurrentSince Jul 18, 2024 Accepting new patients

Locations

1419 SE 8th Ter
Ste 200
Cape Coral, FL 33990

1699 S 14th St
Ste 1
Fernandina Beach, FL 32034
Phone (904) 427-1370

15255 Max Leggett Pkwy
Jacksonville, FL 32218
Phone (904) 383-1000

425 N Lee St
Ste 204
Jacksonville, FL 32204
Phone (904) 277-3477

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

7751 Baymeadows Rd E
Ste 2
Jacksonville, FL 32256
Phone (904) 427-1050

7751 Baymeadows Rd E
Ste 205
Jacksonville, FL 32256
Phone (904) 427-1050

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

3210 Fruitville Rd
Sarasota, FL 34237
Phone (941) 364-8887

Interoperability endpoints

  • Direct secure messaging: mkantarevic119334@direct.shands.ufl.edu

Organizations & group practices 5

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 3

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": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1609649235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 HOLLINGTON DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468459",
            "telephone_number": "904-673-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7751 BAYMEADOWS RD E STE 205",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565836",
            "telephone_number": "904-239-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTAREVIC",
        "first_name": "MARIJA",
        "middle_name": "GLODEVIC",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9316148",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11033264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.