Individual provider Active NPI

Jean Maurice Dure, M.D.

  • General Practice Physician
  • Gainesville, FL
National Provider Identifier
1750572103
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16163 Issued in PR
Practice address
1200 NE 55TH Blvd
Gainesville, FL 32641-2783
Phone
(904) 964-7732
Fax
(904) 964-3829
NPI assigned
Aug 8, 2007
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16163 PR Primary

Addresses

Primary practice location

1200 NE 55TH Blvd
Gainesville, FL 32641-2783

Mailing address

9816 SW 150TH Run
Lake Butler, FL 32054-7120

Other practice location 1

516 Calle Paraguay
San Juan, PR 00917-3963
Phone (401) 749-6019

Other identifiers 2

IdentifierTypeStateIssuer
039796800MedicaidPR
009635300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131101001094 FL Practitioner - General PracticePractitioner - Family Practice 4789819541 Reassigns benefits to 1 organization
I20241001000141 PR Practitioner - General Practice 4789819541 Practice locations: Humacao, PR; Las Piedras, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Children and Families CurrentSince Jul 16, 2020 Accepting new patients
Florida Department of Children and Families Current Accepting new patients

Locations

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

Organizations & group practices 2

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1750572103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 SW 150TH RUN",
            "city": "LAKE BUTLER",
            "state": "FL",
            "postal_code": "320547120",
            "fax_number": "904-964-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NE 55TH BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326412783",
            "telephone_number": "904-964-7732",
            "fax_number": "904-964-3829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Calle Paraguay",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009173963",
            "country_code": "US",
            "telephone_number": "401-749-6019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURE",
        "first_name": "JEAN",
        "middle_name": "MAURICE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039796800",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009635300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.