Individual provider Active NPI

Andrew S. Vihlen, MD

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1790952018
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME109676 Issued in FL
Practice address
1 Shircliff Way
Jacksonville, FL 32886-3026
Phone
(904) 308-7300
Fax
(419) 866-5453
NPI assigned
May 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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 065512 GA
Emergency Medicine Physician 207P00000X ME109676 FL Primary

Addresses

Primary practice location

1 Shircliff Way
Jacksonville, FL 32886-3026

Mailing address

PO Box 863026
Orlando, FL 32886-3026
Phone (800) 288-8325

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
I20111013000176 FL Practitioner - Emergency Medicine 4486830692 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
065512GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Specialists of Jacksonville Emergency Medicine CurrentSince Sep 1, 2011 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 21, 2023 Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Jun 21, 2023 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Dec 1, 2016 Accepting new patients
Emergency Medical Specialists of Jacksonville Emergency Medicine CurrentSince Aug 15, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561

10910 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 407-8500

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Organizations & group practices 5

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1790952018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863026",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863026",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "328863026",
            "telephone_number": "904-308-7300",
            "fax_number": "419-866-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIHLEN",
        "first_name": "ANDREW",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "065512",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME109676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.