Individual provider Active NPI

Jin Hee Ra, MD

  • Surgical Critical Care Physician
  • Jacksonville, FL
National Provider Identifier
1629125380
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
ME107640 Issued in FL
Practice address
655 W 8TH St
Ufjp Surgery Department
Jacksonville, FL 32209-6511
Phone
(904) 383-1015
Fax
(904) 244-4079
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT179830 PA
Surgical Critical Care Physician 2086S0102X ME107640 FL Primary

Addresses

Primary practice location

655 W 8TH St
Ufjp Surgery Department
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Ufjp Surgery Department
Jacksonville, FL 32231-4008

Other identifiers 2

IdentifierTypeStateIssuer
581826893AMedicaidGA
0024329-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190416000332 NC Practitioner - General Surgery 7618008921
I20250505000701 HI Practitioner - General Surgery 7618008921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Louisville School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1329 Lusitana St
Honolulu, HI 96813-2401

1380 Lusitana St
Honolulu, HI 96813-2448

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT179830PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince May 27, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Surgery Current Accepting new patients
The Queen'S Medical Center Current Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Feb 5, 2019 Accepting new patients
The Queens Medical Center CurrentSince May 27, 2025 Accepting new patients
University of North Carolina at Chapel Hill Surgery CurrentSince Feb 5, 2019 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 1, 2010 Accepting new patients
University of Florida Jacksonville Physicians Inc Surgery CurrentSince Aug 1, 2010 Accepting new patients
Queens University Medical Group CurrentSince May 27, 2025 Accepting new patients

Locations

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

653 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3902

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1329 Lusitana St
Ste 207
Honolulu, HI 96813
Phone (808) 439-4923

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

211 Friday Center Dr
Ste 2057
Chapel Hill, NC 27517
Phone (984) 974-1281

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Interoperability endpoints

  • Direct secure messaging: jra505813@direct.unc.nchie.net

Organizations & group practices 9

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

Hospital & facility affiliations 1

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1629125380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP SURGERY DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP SURGERY DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-383-1015",
            "fax_number": "904-244-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RA",
        "first_name": "JIN",
        "middle_name": "HEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT179830",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME107640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "581826893A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0024329-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.