Individual provider Active NPI

Jasmin Tanaja, M.D.

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1780079079
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME134707 Issued in FL
Practice address
1600 SW Archer Rd # 100186
Gainesville, FL 32610
Phone
(404) 727-9934
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME134707 FL Primary
Emergency Medicine Physician 207P00000X 0000000 GA

Addresses

Primary practice location

1600 SW Archer Rd # 100186
Gainesville, FL 32610

Mailing address

1600 SW Archer Rd # 100186
Gainesville, FL 32610-3003

Other identifiers 1

IdentifierTypeStateIssuer
024778900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 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
I20180823002339 FL Practitioner - Emergency Medicine 4789986993 Reassigns benefits to 1 organization
I20190802003047 GA Practitioner - Emergency Medicine 4789986993 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008111GAMDCounselor
0000000GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Mar 18, 2024 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
The Emory Clinic Inc CurrentSince Apr 30, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Aug 1, 2018 Accepting new patients
Emory Specialty Associates, LLC Emergency Medicine CurrentSince Apr 30, 2023 Accepting new patients
Inphynet Primary Care Physicians Southeast PC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Aug 1, 2018 Accepting new patients
Northside Primary Care Professional Services,LLC Past Accepting new patients

Locations

1600 SW Archer Rd
#100371
Gainesville, FL 32610
Phone (352) 265-8335

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
#100186
Gainesville, FL 32610

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

610 Peachtree Pkwy
Ste 100
Cumming, GA 30041
Phone (678) 513-5260

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1780079079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD # 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD # 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32610",
            "telephone_number": "404-727-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAJA",
        "first_name": "JASMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME134707",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "0000000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024778900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.