Individual provider Active NPI

Luis E. Quinones, MD

  • Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1851338818
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME 60608 Issued in FL
Practice address
12058 San Jose Blvd
Suite 903
Jacksonville, FL 32223-1842
Phone
(904) 886-0361
Fax
(904) 886-0382
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X ME 60608 FL
Psychiatry Physician 2084P0800X ME 60608 FL Primary
Forensic Psychiatry Physician 2084F0202X ME 60608 FL

Addresses

Primary practice location

12058 San Jose Blvd
Suite 903
Jacksonville, FL 32223-1842

Mailing address

12058 San Jose Blvd
Suite 903
Jacksonville, FL 32223-1842
Phone (904) 886-0361

Other identifiers 1

IdentifierTypeStateIssuer
375614900MedicaidFL

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
I20051212000036 FL Practitioner - Psychiatry 1850311846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York at Buffalo School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Resource Center IncGroup PAC ID 2567446982, 14 clinicians

Practice addresses (Care Compare)

3333 W 20TH St
Jacksonville, FL 32254-1703
Phone (904) 695-9145

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 60608FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Resource Center Inc CurrentSince Oct 25, 2000 Accepting new patients

Locations

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

11820 Beach Blvd
Jacksonville, FL 32246
Phone (904) 642-9100

4427 Emerson St
Ste 5
Jacksonville, FL 32207
Phone (904) 745-0042

3333 W 20th St
Jacksonville, FL 32254
Phone (904) 384-2364

655 W 8th St
#4S
Jacksonville, FL 32209

Interoperability endpoints

  • Direct secure messaging: lquinones54591@direct.shands.ufl.edu

Organizations & group practices 1

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1851338818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12058 SAN JOSE BLVD",
            "address_2": "SUITE 903",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231842",
            "telephone_number": "904-886-0361",
            "fax_number": "904-886-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12058 SAN JOSE BLVD",
            "address_2": "SUITE 903",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231842",
            "telephone_number": "904-886-0361",
            "fax_number": "904-886-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "LUIS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME 60608",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME 60608",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "FL",
            "license": "ME 60608",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375614900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.