Individual provider Active NPI

Blerina Begolli, M.D.

  • Surgery Physician
  • Panama City, FL
National Provider Identifier
1831253061
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME126480 Issued in FL
Practice address
619 N Cove Blvd
Panama City, FL 32401-3642
Phone
(850) 913-6960
Fax
(850) 913-6961
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X TRN4821 FL
Surgery Physician 208600000X ME126480 FL Primary

Addresses

Primary practice location

619 N Cove Blvd
Panama City, FL 32401-3642

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6014

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
I20160623001988 FL Practitioner - General Surgery 8022309913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

619 N Cove Blvd
Sacred Heart Medical Group
Panama City, FL 32401-3642
Phone (850) 785-9559

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN4821FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Mar 1, 2020 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Surgery Current Accepting new patients
University of Florida Jacksonville Physicians Inc Surgery CurrentSince Jul 1, 2016 Accepting new patients
Sacred Heart Health System Inc CurrentSince Mar 1, 2020 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

653 W 8th St
Fl 3
Jacksonville, FL 32209
Phone (904) 244-3689

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

619 N Cove Blvd
Panama City, FL 32401
Phone (850) 785-9559

801 E 6th St
Ste 606
Panama City, FL 32401
Phone (850) 785-2229

Organizations & group practices 7

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 2

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1831253061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N COVE BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013642",
            "telephone_number": "850-913-6960",
            "fax_number": "850-913-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEGOLLI",
        "first_name": "BLERINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "TRN4821",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME126480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.