NPIMap

Individual provider Active NPI

Perry G Carlos, DO

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1801873443
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS3973 Issued in FL
Practice address
10337 San Jose Blvd Ste 200
Jacksonville, FL 32257-8223
Phone
(904) 260-3200
Fax
(904) 262-8205
NPI assigned
Dec 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS3973 FL Primary

Addresses

Primary practice location

10337 San Jose Blvd Ste 200
Jacksonville, FL 32257-8223

Mailing address

PO Box 45443
Salt Lake City, UT 84145-0443
Phone (904) 202-1032

Other identifiers 2

IdentifierTypeStateIssuer
080162819OtherFLRR MEDICARE
3767451-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100316000416 FL Practitioner - Family Practice 7618002692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

10337 San Jose Blvd
Suite 200
Jacksonville, FL 32257-8223
Phone (904) 260-3200

10601 San Jose Blvd
Jacksonville, FL 32257-8232

Hospital & facility affiliations

  • Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
  • Baptist Home Health Care by Bayada Home health agency, Jacksonville, FL, CCN 107482
  • Pinnacle Home Care Home health agency, Ormond Beach, FL, CCN 108499
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Community Hospice of Northeast Florida Inc Hospice, Jacksonville, FL, CCN 101500
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3973FLMDClinical Psychologist
OS3973FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Oct 1, 2000 Accepting new patients
Baptist Primary Care Inc CurrentSince Oct 1, 2000 Accepting new patients

Locations

10601 San Jose Blvd
Ste 1401
Jacksonville, FL 32257
Phone (904) 260-3200

10337 San Jose Blvd
Ste 200
Jacksonville, FL 32257
Phone (904) 260-3200

10601 San Jose Blvd
Ste 1404
Jacksonville, FL 32257
Phone (904) 202-9204

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

Interoperability endpoints

  • Direct secure messaging: pcarlos28207@baptisthealthsystemjacksonville.direct-ci.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 12

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": "1135555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1801873443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10337 SAN JOSE BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578223",
            "telephone_number": "904-260-3200",
            "fax_number": "904-262-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "PERRY",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-26",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS3973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080162819",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3767451-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.