NPIMap

Organization Active NPI

Cisca Pulmonary Critical Care Inc

  • Pulmonary Disease Physician
  • Jacksonville Beach, FL
National Provider Identifier
1629326285
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
CISCA PULMONARY CRITICAL CARE INC
Practice address
1361 13TH Ave S Ste 245
Jacksonville Beach, FL 32250
Phone
(904) 493-7174
Fax
(904) 694-0696
NPI assigned
Aug 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Alexis Augustine Vazquez, DONPI 1518909167
Title
Physician Owner
Phone
(904) 419-3986

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

1361 13TH Ave S Ste 245
Jacksonville Beach, FL 32250

Mailing address

1361 13TH Ave S Ste 245
Jacksonville Beach, FL 32250-3238
Phone (904) 396-0300

Other practice location 1

3627 University Blvd S Ste 300
Jacksonville, FL 32216-4294
Phone (904) 396-0300

Other identifiers 2

IdentifierTypeStateIssuer
009836500MedicaidFL
2757133-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121113000224 FL Part B Supplier - Clinic/Group Practice 1951552371 Receives reassigned benefits from 8 practitioners
Practice locations: Jacksonville Beach, FL; Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

8773 Perimeter Park Ct
Jacksonville, FL 32216
Phone (904) 493-3390

1361 13th Ave S
Ste 245
Jax Bch, FL 32250
Phone (904) 396-0300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHIDAD

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1629326285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 13TH AVE S STE 245",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503238",
            "telephone_number": "904-396-0300",
            "fax_number": "904-396-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 13TH AVE S STE 245",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "32250",
            "telephone_number": "904-493-7174",
            "fax_number": "904-694-0696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3627 University Blvd S Ste 300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164294",
            "country_code": "US",
            "telephone_number": "904-396-0300",
            "fax_number": "904-396-3039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CISCA PULMONARY CRITICAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_middle_name": "AUGUSTINE",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "904-419-3986",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009836500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2757133-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.