NPIMap

Individual provider Active NPI

Bashir Ahmed, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1861466641
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME89832 Issued in FL
Practice address
7901 James Island TRL
Jacksonville, FL 32256-7379
Phone
(904) 388-2540
Fax
(904) 387-6800
NPI assigned
Feb 16, 2006
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME89832 FL Primary

Addresses

Primary practice location

7901 James Island TRL
Jacksonville, FL 32256-7379

Mailing address

7901 James Island TRL
Jacksonville, FL 32256-7379
Phone (904) 388-2540

Other practice location 1

2149 Saint Johns Ave
Jacksonville, FL 32204-4418
Phone (904) 384-2525

Other identifiers 1

IdentifierTypeStateIssuer
274585200MedicaidFL

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
I20050824000157 FL Practitioner - Internal Medicine 7719918341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Florida Health Solution Inc.Group PAC ID 4385930346, 3 clinicians
Caremax Clinic 711 LLCGroup PAC ID 3577806173, 3 clinicians

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

2732 Trollie LN
Jacksonville, FL 32211-3833
Phone (904) 289-1254

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

Practice roles

OrganizationSpecialtyStatusNew patients
Caremax Clinic 711 LLC Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Northeast Florida Health Solution Inc. Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

2332 Riverside Ave
Jacksonville, FL 32204
Phone (904) 388-2540

2732 Trollie Ln
Jacksonville, FL 32211
Phone (904) 289-1254

2789 Park St
Jacksonville, FL 32205
Phone (904) 289-1254

6400 Brooks Bartram Dr
Jacksonville, FL 32258
Phone (904) 667-4786

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 11

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1861466641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 JAMES ISLAND TRL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567379",
            "telephone_number": "904-388-2540",
            "fax_number": "904-387-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 JAMES ISLAND TRL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567379",
            "telephone_number": "904-388-2540",
            "fax_number": "904-387-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2149 Saint Johns Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044418",
            "country_code": "US",
            "telephone_number": "904-384-2525",
            "fax_number": "904-389-4135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "BASHIR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME89832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274585200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.