Individual provider Active NPI

Justo Maqueira Jr., M.D.

  • Obstetrics & Gynecology Physician
  • Panama City, FL
National Provider Identifier
1790774420
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME64912 Issued in FL
Practice address
103 E 23Rd St
Panama City, FL 32405-4501
Phone
(850) 769-0338
Fax
(850) 785-6088
NPI assigned
Oct 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME64912 FL Primary

Addresses

Primary practice location

103 E 23Rd St
Panama City, FL 32405-4501

Mailing address

103 E 23Rd St
Panama City, FL 32405-4501
Phone (850) 769-0338

Other identifiers 1

IdentifierTypeStateIssuer
379881000MedicaidFL

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
I20101203000846 FL Practitioner - Obstetrics/Gynecology 1355537341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Florida College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

103 E 23Rd St
Panama City, FL 32405-4501
Phone (850) 769-0338

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME64912FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC Obstetrics & Gynecology CurrentSince Jun 1, 2012 Accepting new patients
Gulf Coast Medical Center Primary Care LLC Obstetrics & Gynecology Past Accepting new patients
Womencare PA Past Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

199 S US Highway 17
East Palatka, FL 32131
Phone (386) 325-6699

1800 Jenks Ave
Panama City, FL 32405
Phone (850) 769-3191

103 E 23rd St
Panama City, FL 32405
Phone (850) 769-0338

1002 N Arnold Rd
Unit 303
Panama City Beach, FL 32413
Phone (850) 769-0338

Interoperability endpoints

  • Direct secure messaging: justo.maqueira.1@2183.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1129334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1790774420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054501",
            "telephone_number": "850-769-0338",
            "fax_number": "850-785-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054501",
            "telephone_number": "850-769-0338",
            "fax_number": "850-785-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAQUEIRA",
        "first_name": "JUSTO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-15",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME64912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379881000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.