Individual provider Active NPI

Mohammad Farooq Taj, MD

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1720282106
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME103074 Issued in FL
Practice address
7751 Baymeadows Rd E Ste H
Jacksonville, FL 32256-5836
Phone
(904) 425-6963
Fax
(904) 674-0155
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 103070 MN
Internal Medicine Physician 207R00000X ME103074 FL Primary

Addresses

Primary practice location

7751 Baymeadows Rd E Ste H
Jacksonville, FL 32256-5836

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 3

IdentifierTypeStateIssuer
04615OtherFLBCBS
000778200MedicaidFL
BM181UOtherFLMEDICARE

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
I20090324000654 FL Practitioner - Internal Medicine 5890881486 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

31075 Cortez Blvd
Brooksville, FL 34602-7542
Phone (352) 796-5303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME103074FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Apr 7, 2018 Accepting new patients
Inpatient Consultants of Florida, Inc Internal Medicine CurrentSince Jul 15, 2016 Accepting new patients
North Florida Acute Care Specialists LLC Internal Medicine CurrentSince Feb 1, 2009 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Apr 7, 2018 Accepting new patients
Inpatient Consultants of Florida Inc Internal Medicine CurrentSince Jul 15, 2016 Accepting new patients
North Florida Gastroenterology LLC PastSince Feb 1, 2009 Accepting new patients
Healtheast Medical Research Institute Internal Medicine Past Accepting new patients

Locations

14540 Cortez Blvd
Ste 102
Brooksville, FL 34613
Phone (352) 596-7255

31075 Cortez Blvd
Brooksville, FL 34602
Phone (352) 796-5303

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

7751 Baymeadows Rd E
Ste H
Jacksonville, FL 32256
Phone (904) 425-6963

7011 A C Skinner Pkwy
Ste 160
Jacksonville, FL 32256
Phone (904) 642-0877

7685 103rd St
Jacksonville, FL 32210
Phone (904) 425-6963

2045 Professional Center Dr
#D
Orange Park, FL 32073
Phone (904) 276-1580

2045 Professional Center Dr
Orange Park, FL 32073
Phone (904) 276-6903

2029 Professional Center Dr
Orange Park, FL 32073
Phone (570) 352-3063

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Interoperability endpoints

  • Direct secure messaging: mohammad.taj.1@4290.direct.athenahealth.com

Organizations & group practices 7

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 6

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1720282106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7751 BAYMEADOWS RD E STE H",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565836",
            "telephone_number": "904-425-6963",
            "fax_number": "904-674-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJ",
        "first_name": "MOHAMMAD",
        "middle_name": "FAROOQ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "103070",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME103074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04615",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000778200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "BM181U",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.