NPIMap

Organization Active NPI

Northeast Florida Endocrine and Diabetes Associates, PA

  • Specialist
  • St Johns, FL
National Provider Identifier
1699412932
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES, PA
Practice address
300 Saint Elizabeth Way Ste 160
St Johns, FL 32259-1153
Phone
(904) 384-2240
Fax
(904) 486-2314
NPI assigned
May 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Elena M Oravetz
Title
Credentials
Phone
(904) 384-2240

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

300 Saint Elizabeth Way Ste 160
St Johns, FL 32259-1153

Mailing address

915 W Monroe St Ste 200
Jacksonville, FL 32204-1177
Phone (904) 384-2240

National Provider Directory

National Provider Directory
Tax ID family
N E FL Endocrine Diab14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1699412932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SAINT ELIZABETH WAY STE 160",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591153",
            "telephone_number": "904-384-2240",
            "fax_number": "904-486-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA ENDOCRINE AND DIABETES ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "ORAVETZ",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALS",
        "authorized_official_telephone_number": "904-384-2240"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.