NPIMap

Individual provider Active NPI

Misbah I Farooqi, M.D.

  • Internal Medicine Physician
  • Blountstown, FL
National Provider Identifier
1710986286
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME69137 Issued in FL
Practice address
20454 NE Finley Ave
Blountstown, FL 32424-6012
Phone
(850) 674-2221
Fax
(850) 674-2221
NPI assigned
Jul 18, 2005
Last updated
Nov 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME69137 FL Primary

Addresses

Primary practice location

20454 NE Finley Ave
Blountstown, FL 32424-6012

Mailing address

20454 NE Finley Ave
Blountstown, FL 32424-6012
Phone (850) 674-2221

Other identifiers 1

IdentifierTypeStateIssuer
379214500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001123 FL Practitioner - Internal Medicine 7113817792 Reassigns benefits to 3 organizations
Practice locations: Blountstown, FL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center LLCGroup PAC ID 2062322373, 3 clinicians

Practice addresses (Care Compare)

16257 State Rd 71
Blountstown, FL 32424-2808
Phone (850) 674-5411

20370 NE Burns Ave
Blountstown, FL 32424-1045

20454 NE Finley Ave
Blountstown, FL 32424-6012
Phone (850) 674-2221

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME69137FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Children and Families CurrentSince Jul 1, 2021 Accepting new patients
Bittern Emergency Physicians, LLC CurrentSince Jun 1, 2019 Accepting new patients
Florida Department of Children and Families Current Accepting new patients
Florida Department of Children and Families CurrentSince Jul 1, 2021 Accepting new patients
Pancare of Florida, Inc PastSince Aug 1, 2019 Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients
Calhoun Liberty Hospital Association, Inc. Past Accepting new patients
Dassee Community Health Systems Past Accepting new patients

Locations

16257 State Road 71 S
Blountstown, FL 32424
Phone (850) 674-5411

20370 NE Burns Ave
Blountstown, FL 32424
Phone (850) 237-3000

100 N Main St
Chattahoochee, FL 32324
Phone (850) 663-7001

100 N Main St
Bldg 1028
Chattahoochee, FL 32324
Phone (904) 330-2215

7487 S State Road 121
Macclenny, FL 32063
Phone (904) 259-6211

Interoperability endpoints

  • Direct secure messaging: aoffice@ppdxdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Blountstown Health and Rehabilitation CenterBlountstown, FL, CCN 105924 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 15, 2022
Feb 15, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1710986286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20454 NE FINLEY AVE",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324246012",
            "telephone_number": "850-674-2221",
            "fax_number": "850-674-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20454 NE FINLEY AVE",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324246012",
            "telephone_number": "850-674-2221",
            "fax_number": "850-674-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAROOQI",
        "first_name": "MISBAH",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME69137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379214500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blountstown, FL

Sources for this page

Verify at the official NPI Registry.