NPIMap

Organization Active NPI

Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
National Provider Identifier
1821155912
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
4304 Issued in FL
Legal business name
BAPTIST MEDICAL CENTER OF THE BEACHES, INC
Practice address
1350 13TH Ave S
Jacksonville Beach, FL 32250-3203
Phone
(904) 376-4182
Fax
(904) 376-4280
NPI assigned
Jan 2, 2007
Last updated
Jun 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Philip Boyce
Title
Chief Revenue Officer
Phone
(904) 376-3760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 4304 FL Primary

Addresses

Primary practice location

1350 13TH Ave S
Jacksonville Beach, FL 32250-3203

Mailing address

P O Box 45058
Jacksonville, FL 32232-5058
Phone (904) 376-4182

Other identifiers 3

IdentifierTypeStateIssuer
010232600MedicaidFL
00150345AOtherGAMEDICAID OF GA PROVIDER
128OtherFLBLUE CROSS PROVIDER NUMBE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BaptistJAXHIM@direct.bmcjax.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111214000183 FL Part A Provider - Hospital 6002842762 Practice locations: Jacksonville, FL; Jacksonville Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821155912. Details of each certification follow.

Hospital certification: CCN 100117

Legal name
BAPTIST MEDICAL CENTER OF THE BEACHES, INC
Doing business as
BAPTIST MEDICAL CENTER BEACHES
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 3, 2010
Beds
146
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Nov 27, 1989 in FL
Enrollment address
1350 13TH Ave S
Baptist Medical Center Beaches
Jacksonville Beach, FL 32250-3203
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Baptist Medical Center BeachesCCN 100117 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0645124Baptist Medical Center-Beaches1350 13TH Ave South, Jacksonville Beach, FL 32250AccreditationJan 2, 2027

National Provider Directory

National Provider Directory

Locations

841 Prudential Dr
Ste 1330
Jacksonville, FL 32207
Phone (904) 244-3050

1320 Roberts Dr
Jacksonville Beach, FL 32250
Phone (904) 627-1376

1577 Roberts Dr
Jacksonville Beach, FL 32250
Phone (904) 709-4510

1370 13th Ave S
Jax Bch, FL 32250
Phone (904) 376-4130

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sonny Bhikha Individual Corporate DirectorBoard Member Sep 1, 2005
Peter Ghiloni Individual Corporate DirectorBoard Member Mar 1, 2010
Philip Boyce Individual Corporate OfficerSr VP and Chief Rev Officer Jan 1, 2020
Ernest Bono Individual Corporate DirectorBoard Member Mar 3, 2003
Baptist Health System Inc Organization, Jacksonville, FL Corporation 5% Or Greater Direct Ownership Interest Aug 29, 1983
Howard Serkin Individual Corporate DirectorBoard Member Mar 10, 2008
Thomas Finnegan Individual W-2 Managing EmployeeVP Finance Jul 31, 1995
Carol Thompson Individual Corporate DirectorBoard Member Aug 28, 2000
Nathaniel Herring Individual Corporate DirectorBoard Member Mar 1, 2010
Matthew Zuino Individual Corporate OfficerEvp and Coo Jul 16, 2021
Nancy Broner Individual Corporate DirectorBoard Member Mar 14, 2011

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 25

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 25

Affiliated clinicians 1,088

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,088

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1821155912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 45058",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322325058",
            "telephone_number": "904-376-4182",
            "fax_number": "904-376-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 13TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503203",
            "telephone_number": "904-376-4182",
            "fax_number": "904-376-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEDICAL CENTER OF THE BEACHES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "BOYCE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "904-376-3760"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "4304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010232600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF GA PROVIDER",
            "identifier": "00150345A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "128",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BaptistJAXHIM@direct.bmcjax.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1350 13th Ave S",
            "city": "Jacksonville Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322503203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.