Individual provider Active NPI

Iman Naseri, M.D.

  • Otolaryngology Physician
  • Jacksonville, FL
National Provider Identifier
1700060555
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME105498 Issued in FL
Practice address
6817 Southpoint Parkway
Suite 502
Jacksonville, FL 32216-6289
Phone
(904) 595-7475
Fax
(904) 595-7480
NPI assigned
Dec 27, 2007
Last updated
Mar 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 056201 GA
Otolaryngology Physician 207Y00000X ME105498 FL Primary

Addresses

Primary practice location

6817 Southpoint Parkway
Suite 502
Jacksonville, FL 32216-6289

Mailing address

6817 Southpoint Parkway Suite 502
Jacksonville, FL 32216-6289
Phone (904) 595-7475

Other identifiers 3

IdentifierTypeStateIssuer
P01368157OtherFLRR MEDICARE
0013083-00MedicaidFL
478745301AMedicaidGA

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
I20091015000650 FL Practitioner - Otolaryngology 4082750476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Medical University of South Carolina College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

6817 Southpoint Pkwy
Suite 502
Jacksonville, FL 32216-6289
Phone (904) 595-7475

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
056201GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Sinus Center Otolaryngology Current Accepting new patients
North Florida Surgeons, PA CurrentSince Jun 1, 2021 Accepting new patients
North Florida Surgeons, PA CurrentSince Jun 1, 2021 Accepting new patients

Locations

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

14546 Old St Augustine Rd
Ste 401
Jacksonville, FL 32258
Phone (904) 268-5366

6817 Southpoint Pkwy
Ste 502
Jacksonville, FL 32216
Phone (904) 595-7475

836 Prudential Dr
Ste 1601
Jacksonville, FL 32207
Phone (904) 396-2400

Interoperability endpoints

  • Direct secure messaging: iman.naseri.1@9109.direct.athenahealth.com
  • Direct secure messaging: inaseri@entaaf.emadirect.md
  • Direct secure messaging: inaseri59433@direct.shands.ufl.edu

Organizations & group practices 5

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 3

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": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1700060555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PARKWAY SUITE 502",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166289",
            "telephone_number": "904-595-7475",
            "fax_number": "904-595-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PARKWAY",
            "address_2": "SUITE 502",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166289",
            "telephone_number": "904-595-7475",
            "fax_number": "904-595-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASERI",
        "first_name": "IMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "056201",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME105498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01368157",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013083-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "478745301A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.