NPIMap

Individual provider Active NPI

Fara Nadal, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1659343796
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME61612 Issued in FL
Practice address
5491 Dolphin Point Blvd Ste 3110
Jacksonville, FL 32211-3221
Phone
(904) 744-5244
Fax
(904) 390-7474
NPI assigned
Feb 3, 2006
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME61612 FL Primary

Addresses

Primary practice location

5491 Dolphin Point Blvd Ste 3110
Jacksonville, FL 32211-3221

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092

Other identifiers 2

IdentifierTypeStateIssuer
379291900MedicaidFL
P00112716OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040826000634 FL Practitioner - Family Practice 3375518111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

7001 Merrill Rd
Suite 10
Jacksonville, FL 32277-2691
Phone (904) 744-5244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME61612FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Jun 1, 2004 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients
Baptist Primary Care Inc. Family Medicine CurrentSince Jun 1, 2004 Accepting new patients
Baptist Primary Care Inc Family Medicine Past Accepting new patients

Locations

5491 Dolphin Point Blvd
Ste 3110
Jacksonville, FL 32211
Phone (904) 744-5244

5566 Fort Caroline Rd
Ste 20
Jacksonville, FL 32277
Phone (904) 744-5244

7001 Merrill Rd
Ste 10
Jacksonville, FL 32277
Phone (904) 744-5244

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

Interoperability endpoints

  • Direct secure messaging: fnadaldavila28180@baptisthealthsystemjacksonville.direct-ci.com

Organizations & group practices 4

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 11

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1659343796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5491 DOLPHIN POINT BLVD STE 3110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322113221",
            "telephone_number": "904-744-5244",
            "fax_number": "904-390-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADAL",
        "first_name": "FARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME61612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379291900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00112716",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.