NPIMap

Organization Active NPI

Internal Medicine Associates of St Johns County PA

  • Internal Medicine Physician
  • St Augustine, FL
National Provider Identifier
1699704841
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
207R00000X Issued in FL
Legal business name
INTERNAL MEDICINE ASSOCIATES OF ST JOHNS COUNTY PA
Practice address
16 St Johns Medical PK Dr
St Augustine, FL 32086-5299
Phone
(904) 794-5411
Fax
(904) 794-4224
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Authorized official

Name
Joseph R Rozas, M.D.NPI 1174554737
Title
Partner
Phone
(904) 794-5411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 207R00000X FL Primary

Addresses

Primary practice location

16 St Johns Medical PK Dr
St Augustine, FL 32086-5299

Mailing address

16 St Johns Medical Park Dr
St Augustine, FL 32086-5299
Phone (904) 794-5411

Other identifiers 1

IdentifierTypeStateIssuer
251686100MedicaidFL

National Provider Directory

National Provider Directory

Locations

381 Palm Coast Pkwy SW
Unit 5
Palm Coast, FL 32137
Phone (386) 446-4255

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1699704841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ST JOHNS MEDICAL PARK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865299",
            "telephone_number": "904-794-5411",
            "fax_number": "904-794-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ST JOHNS MEDICAL PK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865299",
            "telephone_number": "904-794-5411",
            "fax_number": "904-794-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF ST JOHNS COUNTY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "ROZAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "904-794-5411",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "207R00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251686100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.