Individual provider Active NPI

Amir Azarbal, M.D.

  • Cardiovascular Disease Physician
  • Jacksonville, FL
National Provider Identifier
1679830632
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
155596 Issued in FL
Practice address
3900 University Blvd S
Jacksonville, FL 32216-4331
Phone
(904) 222-6656
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 155596 FL Primary
Cardiovascular Disease Physician 207RC0000X 64000 CT

Addresses

Primary practice location

3900 University Blvd S
Jacksonville, FL 32216-4331

Mailing address

3900 University Blvd S
Jacksonville, FL 32216-4331
Phone (904) 222-6656

Other practice location 1

301 Governors Dr SW
Huntsville, AL 35801-5123
Phone (256) 551-4652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220615001220 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7315182649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashchi Heart and Vascular Center PAGroup PAC ID 0941519979, 9 clinicians

Practice addresses (Care Compare)

3900 University S Blvd a
Jacksonville, FL 32216-4391
Phone (904) 222-6656

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting41
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155596FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialists in Cardiovascular Medicine, PC Cardiovascular Disease CurrentSince Jul 1, 2020 Accepting new patients
Ashchi Heart & Vascular Center PA Cardiovascular Disease CurrentSince Jul 15, 2022 Accepting new patients
Bagnoli and Salah Partnership PastSince Jul 15, 2022 Accepting new patients

Locations

3900 University Blvd S
Jacksonville, FL 32216
Phone (904) 222-6656

3900 University Blvd S
Ste A
Jacksonville, FL 32216
Phone (904) 222-6656

125 Daugherty Dr
Ste 301
Monroeville, PA 15146
Phone (412) 856-4666

Organizations & group practices 3

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 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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1679830632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164331",
            "telephone_number": "904-222-6656",
            "fax_number": "904-222-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164331",
            "telephone_number": "904-222-6656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Governors Dr SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358015123",
            "country_code": "US",
            "telephone_number": "256-551-4652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZARBAL",
        "first_name": "AMIR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "155596",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "64000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.