NPIMap

Individual provider Active NPI

Abdul Q. Jumani, M.D,FACP.

  • Nephrology Physician
  • Port Orange, FL
National Provider Identifier
1861425936
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME94867 Issued in FL
Practice address
4641 S Clyde Morris Blvd
Suite 201
Port Orange, FL 32129-6003
Phone
(386) 322-6340
NPI assigned
Jul 9, 2006
Last updated
Dec 31, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME94867 FL Primary

Addresses

Primary practice location

4641 S Clyde Morris Blvd
Suite 201
Port Orange, FL 32129-6003

Mailing address

4641 S Clyde Morris Blvd
Suite 201
Port Orange, FL 32129-6003
Phone (386) 322-6340

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
I20070815000016 FL Practitioner - NephrologyPractitioner - Internal Medicine 6002907490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4645 S Clyde Morris Blvd
Suite 408
Port Orange, FL 32129-3005
Phone (386) 322-6340

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME94867FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Volusia Renal Consultants LLC Nephrology CurrentSince Jan 1, 2010 Accepting new patients
Renal Care Consultants PL Nephrology PastSince Jul 1, 2008 Accepting new patients

Locations

4645 Clyde Morris Blvd
#4
Port Orange, FL 32129
Phone (386) 322-6340

4645 Clyde Morris Blvd
Ste 408
Port Orange, FL 32129
Phone (386) 295-6601

Organizations & group practices 2

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 9

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1861425936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 S CLYDE MORRIS BLVD",
            "address_2": "SUITE 201",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296003",
            "telephone_number": "386-322-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 S CLYDE MORRIS BLVD",
            "address_2": "SUITE 201",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296003",
            "telephone_number": "386-322-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMANI",
        "first_name": "ABDUL",
        "middle_name": "Q.",
        "name_prefix": "Dr.",
        "credential": "M.D,FACP.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME94867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.