NPIMap

Organization Active NPI

Pulmonary Associates of St

  • Pulmonary Disease Physician
  • St Augustine, FL
National Provider Identifier
1801999545
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY ASSOCIATES OF ST
Practice address
300 Health Park Blvd Ste 4000
St Augustine, FL 32086-3704
Phone
(904) 824-8666
Fax
(904) 824-8933
NPI assigned
Sep 7, 2006
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Kishwar Husain, MDNPI 1912000696
Title
Owner
Phone
(904) 824-8666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

300 Health Park Blvd Ste 4000
St Augustine, FL 32086-3704

Mailing address

300 Health Park Blvd Ste 4000
St Augustine, FL 32086-3704
Phone (412) 822-7410

Other practice location 1

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 824-8666

Other identifiers 2

IdentifierTypeStateIssuer
DD4747OtherFLRAILROAD MEDICARE
272728500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041012001229 FL Part B Supplier - Clinic/Group Practice 0749240018 Receives reassigned benefits from 12 practitioners
Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1801999545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD STE 4000",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863704",
            "telephone_number": "412-822-7410",
            "fax_number": "412-822-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD STE 4000",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863704",
            "telephone_number": "904-824-8666",
            "fax_number": "904-824-8933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865784",
            "country_code": "US",
            "telephone_number": "904-824-8666",
            "fax_number": "904-824-8933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PULMONARY ASSOCIATES OF ST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "HUSAIN",
        "authorized_official_first_name": "KISHWAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-824-8666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD4747",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272728500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.