Individual provider Active NPI

Kathryn Mince Eraso, MD

  • Obstetrics & Gynecology Physician
  • Orange Park, FL
National Provider Identifier
1710305396
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME135926 Issued in FL
Practice address
1887 Kingsley Ave Ste 1500
Orange Park, FL 32073-4481
Phone
(904) 633-0880
Fax
(904) 633-0881
NPI assigned
Apr 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X ME135926 FL Primary

Addresses

Primary practice location

1887 Kingsley Ave Ste 1500
Orange Park, FL 32073-4481

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 633-0880

Other practice location 1

1887 Kingsley Ave Ste 1500
Orange Park, FL 32073-4481
Phone (904) 633-0880

Other practice location 2

1887 Kingsley Ave Ste 1500
Orange Park, FL 32073-4481
Phone (904) 633-0880

Other practice location 3

Stony Brook Medicine Department Of Ob Gyn
101 Nicolls Road
Stony Brook, NY 11794-8091
Phone (631) 444-4686

Other names 1

  • Kathryn Mince Professional name

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
I20181113002577 FL Practitioner - Obstetrics/Gynecology 9931453883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-7874

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME135926FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Aug 6, 2018 Accepting new patients
University of Florida Jacksonville Physicians Inc Obstetrics & Gynecology CurrentSince Aug 6, 2018 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

653 W 8th St
Jacksonville, FL 32209
Phone (904) 244-3902

1887 Kingsley Ave
Ste 1500
Orange Park, FL 32073
Phone (904) 244-3112

Interoperability endpoints

  • Direct secure messaging: keraso339314@direct.shands.ufl.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1710305396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-633-0880",
            "fax_number": "904-633-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE STE 1500",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734481",
            "telephone_number": "904-633-0880",
            "fax_number": "904-633-0881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1887 Kingsley Ave Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734481",
            "country_code": "US",
            "telephone_number": "904-633-0880",
            "fax_number": "904-633-0881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1887 Kingsley Ave Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734481",
            "country_code": "US",
            "telephone_number": "904-633-0880",
            "fax_number": "904-633-0881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Stony Brook Medicine Department Of Ob Gyn",
            "address_2": "101 Nicolls Road",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948091",
            "country_code": "US",
            "telephone_number": "631-444-4686",
            "fax_number": "631-444-4622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERASO",
        "first_name": "KATHRYN",
        "middle_name": "MINCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME135926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "MINCE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.