Individual provider Active NPI

Karim Jacob Samara, MD

  • Ophthalmology Physician
  • Jacksonville, FL
National Provider Identifier
1700844420
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME91598 Issued in FL
Practice address
3316 3Rd St S
Suite 103
Jacksonville, FL 32250-6073
Phone
(904) 241-7865
NPI assigned
May 2, 2006
Last updated
Mar 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME91598 FL
Internal Medicine Physician 207R00000X ME91598 FL
Ophthalmology Physician 207W00000X ME91598 FL Primary

Addresses

Primary practice location

3316 3Rd St S
Suite 103
Jacksonville, FL 32250-6073

Mailing address

3316 3Rd St S
Suite 103
Jacksonville, FL 32250-6073
Phone (904) 241-7865

Other identifiers 1

IdentifierTypeStateIssuer
278103400MedicaidFL

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
I20061114000096 FL Practitioner - OphthalmologyPractitioner - Geriatric Medicine 5698773356 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Geriatric Medicine
Education
University of Florida College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Eye Institute, P.a.Group PAC ID 2466434386, 10 clinicians

Practice addresses (Care Compare)

3316 3Rd St S
Suite 103
Jacksonville, FL 32250-6090
Phone (904) 241-7865

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery314

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME91598FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harris Wilcox and Donovan PA Ophthalmology Current Accepting new patients
Atlantic Eye Institute, P.a. Ophthalmology CurrentSince Jun 1, 2012 Accepting new patients
Atlantic Eye Institute P.a. Ophthalmology CurrentSince Jun 1, 2012 Accepting new patients
Harris Wilcox and Donovan PA Ophthalmology CurrentSince Oct 1, 2021 Accepting new patients
Harris Wilcox and Donovan P a Ophthalmology CurrentSince Oct 1, 2021 Accepting new patients
First Coast LTC Inc CurrentSince May 1, 2007 Accepting new patients

Locations

13457 Atlantic Blvd
Ste 4
Jacksonville, FL 32225

6207 Bennett Rd
Jacksonville, FL 32216
Phone (904) 241-7865

6555 Chester Ave
Ste 1
Jacksonville, FL 32217
Phone (904) 265-8209

3316 3rd St S
Ste 103
Jax Bch, FL 32250
Phone (904) 241-7865

2023 Professional Center Dr
Orange Park, FL 32073
Phone 9042722020234

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1700844420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 3RD ST S",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322506073",
            "telephone_number": "904-241-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 3RD ST S",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322506073",
            "telephone_number": "904-241-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARA",
        "first_name": "KARIM",
        "middle_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME91598",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME91598",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME91598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278103400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.