Talat Imam, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME71382 Issued in FL

Practice address

10058 Baymeadows Rd
Jacksonville, FL 32256-7177

Phone

(904) 636-5400

Fax

(904) 928-0654

NPI assigned

Jul 11, 2006

Last updated

Dec 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

University of Florida College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307
• Ascension St Vincent's Riverside Hospital, Jacksonville, FL, CCN 100040

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: talat.imam.1@8967.direct.athenahealth.com

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.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment Care Compare group NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent's Medical Center, Inc.

  dba Ascension St Vincent's Riverside

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1710912654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10058 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567177",
            "telephone_number": "904-636-5400",
            "fax_number": "904-928-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10058 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567177",
            "telephone_number": "904-636-5400",
            "fax_number": "904-928-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAM",
        "first_name": "TALAT",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME71382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254712100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018008600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imagine Medical International LLC (Imagine Medical International)
• Imaging Center at Forbes LLC
• Imaging Center at Lakewood LLC
• Imaging Services of Jacksonville LLC
• Hussain S Imam, MD
• Erica Imaoka, DNP
• David Mathew Imbt, M.D.
• Mary Imhansiemhonehi
• Immediate Medical Care Corp (Immediate Medical Care, P.A.)
• Impact 13 Medical, PLLC

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.