Active NPI
Stephen Bagnoli, M.D.
- Pulmonary Disease Physician
- Jacksonville, FL
National Provider Identifier
1649270638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- ME0045005
- Practice address
- 3599 University Blvd S
Suite 901
Jacksonville, FL 32216-4252 - Phone
- (904) 398-6971
- Fax
- (904) 398-2497
- NPI assigned
- Jul 31, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | ME0045005 | FL | Primary |
Addresses
Primary practice location
3599 University Blvd S
Suite 901
Jacksonville, FL 32216-4252
Mailing address
3599 University Blvd S
Suite 901
Jacksonville, FL 32216-4252
Phone (904) 398-6971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036050300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.46 of 100
- Quality
- 91.35
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 81
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0045005 | FL | MD | Pulmonary Disease Physician |
Organizations & group practices 1
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.
-
- Pulmonary Disease Physician
- Jacksonville, FL
- NPI 1144287335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396915200000",
"number": "1649270638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3599 UNIVERSITY BLVD S",
"address_2": "SUITE 901",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164252",
"telephone_number": "904-398-6971",
"fax_number": "904-398-2497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3599 UNIVERSITY BLVD S",
"address_2": "SUITE 901",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164252",
"telephone_number": "904-398-6971",
"fax_number": "904-398-2497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGNOLI",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-31",
"last_updated": "2014-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "FL",
"license": "ME0045005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036050300",
"state": "FL"
}
],
"endpoints": [],
"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 Apr 8, 2014; 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.