Individual provider Active NPI

Jaime Mejia, M.D.

  • Diagnostic Radiology Physician
  • Hollywood, FL
National Provider Identifier
1780763565
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME66279 Issued in FL
Practice address
5920 Johnson St
Suite 104
Hollywood, FL 33021-5652
Phone
(954) 894-6022
Fax
(954) 894-6023
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME66279 FL Primary

Addresses

Primary practice location

5920 Johnson St
Suite 104
Hollywood, FL 33021-5652

Mailing address

5920 Johnson St
Suite 104
Hollywood, FL 33021-5652
Phone (954) 894-6022

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
I20071002000842 FL Practitioner - Diagnostic Radiology 2062507213 Reassigns benefits to 4 organizations
Practice locations: St Petersburg, FL

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1751 David Walker Dr
Tavares, FL 32778-5745
Phone (352) 800-6500

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rose Radiology Centers, LLC CurrentSince Mar 1, 2020 Accepting new patients
National Nuclear Centers, Inc CurrentSince Dec 5, 2020 Accepting new patients
Elite Imaging, LLC Diagnostic Radiology Past Accepting new patients
Radiology Imaging Specialists LLC Diagnostic Radiology PastSince Jun 6, 2021 Accepting new patients
The Family Health Center of Broward PastSince Sep 5, 2008 Accepting new patients

Locations

1220 Oakfield Dr
Brandon, FL 33511
Phone (813) 655-1144

4224 Hollywood Blvd
Hollywood, FL 33021
Phone (954) 966-3600

8300 W Sunrise Blvd
Plantation, FL 33322
Phone (954) 577-6000

6900 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 783-6736

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1780763565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 JOHNSON ST",
            "address_2": "SUITE 104",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215652",
            "telephone_number": "954-894-6022",
            "fax_number": "954-894-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 JOHNSON ST",
            "address_2": "SUITE 104",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215652",
            "telephone_number": "954-894-6022",
            "fax_number": "954-894-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "JAIME",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME66279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.