Mario Alberto Iraheta Abrego, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME147054 Issued in FL

Practice address

1714 N Main St
Jacksonville, FL 32206-4404

Phone

(904) 354-6868

Fax

(904) 358-3067

NPI assigned

Aug 22, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mario A Iraheta Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855

  Pediatrics

  Medicare reassignment NPD
• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1740056886
  NPD
• Saltzman, Tanis, Pittell, Levin and Jacobson

  • Pediatrics Physician
  • Hollywood, FL
  • NPI 1639138480
  NPD (past)

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1689954760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "904-354-6868",
            "fax_number": "904-358-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 N MAIN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064404",
            "telephone_number": "904-354-6868",
            "fax_number": "904-358-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRAHETA ABREGO",
        "first_name": "MARIO",
        "middle_name": "ALBERTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME147054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108158500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mario.irahetaabrego@pedsassoc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1714 N Main St",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322064404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIO",
            "last_name": "IRAHETA",
            "middle_name": "A",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Iovanovici
• Deanna Iovino, LCSW
• Hasan Iqbal
• Madiha Iqbal, MBBS
• Ira Harmon MD PA
• Anushka Irani, BM BCH DPHIL MRCP
• Sarosh Rohintan Irani, BMBCH DPHIL FRCP
• Jose Enrique Irazuzta, M.D.
• B. Freeman Irby, M.D.
• Irc Medical, LLC

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.