NPIMap

Organization Active NPI

Northeast Florida Endocrine and Diabetes Associates, PA

  • Specialist
  • Saint Johns, FL
National Provider Identifier
1619697034
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES, PA
Practice address
300 Saint Elizabeth Way Ste 270
St Johns, FL 32259-1152
Phone
(904) 384-2240
Fax
(904) 486-2314
NPI assigned
Aug 29, 2022
Last updated
Jun 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHEAST FLORIDA ENDOCRINE & DIABETES ASSOCIATES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Elena M Oravetz
Title
Credentialing
Phone
(904) 384-2240

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

300 Saint Elizabeth Way Ste 270
St Johns, FL 32259-1152

Mailing address

915 W Monroe St Ste 200
Jacksonville, FL 32204-1177
Phone (904) 384-2240

National Provider Directory

National Provider Directory
Tax ID family
NE Fla Endocrine Diab14 organizations share this tax ID, including this one
Part of
NE Fla Endocrine Diab

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1619697034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SAINT ELIZABETH WAY STE 270",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591152",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST FLORIDA ENDOCRINE & DIABETES ASSOCIATES, PA",
        "enumeration_date": "2022-08-29",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "ORAVETZ",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "904-384-2240"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.