NPIMap

Individual provider Active NPI

Abdi Abbassi, M.D.

  • Gastroenterology Physician
  • Jacksonville, FL
National Provider Identifier
1831183938
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME0070964 Issued in FL
Practice address
2 Shircliff Way Ste 435
Jacksonville, FL 32204
Phone
(904) 388-8686
NPI assigned
Sep 2, 2005
Last updated
Oct 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME0070964 FL Primary

Addresses

Primary practice location

2 Shircliff Way Ste 435
Jacksonville, FL 32204

Mailing address

2 Shircliff Way Ste 435
Jacksonville, FL 32204

Other names 1

  • Dr. Abdolreza Abbassi Former name

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
I20031209001048 FL Practitioner - Gastroenterology 1850204116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease ConsultantsGroup PAC ID 1850515040, 18 clinicians

Practice addresses (Care Compare)

2151 Riverside Ave
Jacksonville, FL 32204-4416
Phone (904) 388-8686

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy149
Upper gastrointestinal (GI) endoscopy for acid reflux215

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0070964FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Consultants Gastroenterology CurrentSince Oct 9, 2019 Accepting new patients
American Physicians Foundation Corporation CurrentSince Apr 30, 2003 Accepting new patients
Riverside Endoscopy Center LLC PastSince Sep 1, 2013 Accepting new patients
American Anesthesiology of North Florida LLC Past Accepting new patients
Kingsley Endoscopy Center LLC PastSince Jan 1, 2021 Accepting new patients

Locations

2 Shircliff Way
Ste 435
Jacksonville, FL 32204
Phone (904) 308-6900

2151 Riverside Ave
Jacksonville, FL 32204
Phone (904) 381-8900

3 Shircliff Way
Ste 615
Jacksonville, FL 32204
Phone (904) 388-6003

Interoperability endpoints

  • Direct secure messaging: abdia@amerpf.curemd.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1831183938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 435",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 435",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-388-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBASSI",
        "first_name": "ABDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0070964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABDOLREZA",
            "last_name": "ABBASSI",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.