Individual provider Active NPI

Craig R Cazenave, MD

  • Diagnostic Radiology Physician
  • Fort Walton Beach, FL
National Provider Identifier
1861463937
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME42584 Issued in FL
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(614) 210-1885
Fax
(614) 210-1886
NPI assigned
Jan 27, 2006
Last updated
Nov 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME42584 FL Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (614) 210-1885

Other identifiers 16

IdentifierTypeStateIssuer
104206MedicaidAL
104468MedicaidAL
107070MedicaidAL
109478MedicaidAL
000101258MedicaidAL
108288MedicaidAL
104470MedicaidAL
104236MedicaidAL
104466MedicaidAL
104205MedicaidAL
048160200MedicaidFL
05668OtherFLBCBS
104250MedicaidAL
107073MedicaidAL
104239MedicaidAL
108893MedicaidAL

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
I20050302000560 FL Practitioner - Diagnostic Radiology 7113994872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Florida College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2115 Little Rd
Trinity, FL 34655-4410
Phone (904) 399-5550

2626 Capital Medical Blvd
Tallahassee, FL 32308-4402
Phone (904) 399-5550

6001 Webb Rd
Tampa, FL 33615-3241
Phone (904) 339-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME42584FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients
Sheridan Radiology Services of Central Florida Inc Diagnostic Radiology Current Accepting new patients
Medical Evaluators Inc CurrentSince Oct 1, 2004 Accepting new patients
Sheridan Radiology Services of Central Florida, Inc. Diagnostic Radiology Past Accepting new patients
Bay Radiology Associates, PL Diagnostic Radiology PastSince Jul 12, 2004 Accepting new patients
Bay Radiology Womens Imaging Center, LLC Diagnostic Radiology PastSince Jan 4, 2010 Accepting new patients

Locations

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

1100 NW 95th St
Miami Shores, FL 33150
Phone (305) 835-6000

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

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 5

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1861463937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "614-210-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "614-210-1885",
            "fax_number": "614-210-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAZENAVE",
        "first_name": "CRAIG",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME42584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104206",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104468",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107070",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109478",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000101258",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108288",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104470",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104236",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104466",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104205",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048160200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05668",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104250",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107073",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104239",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108893",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.