Individual provider Active NPI

Ivan J Briones, M.D.

  • Adult Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1861654642
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
D74732 Issued in MD
Practice address
6900 Southpoint Dr N
Jacksonville, FL 32216-8007
Phone
(904) 470-6900
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 237274 MA
Family Medicine Physician 207Q00000X P1275 TX
Adult Medicine Physician 207QA0505X D74732 MD Primary

Addresses

Primary practice location

6900 Southpoint Dr N
Jacksonville, FL 32216-8007

Mailing address

1536 N Jefferson St
Jacksonville, FL 32209-6525
Phone (904) 475-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20130404000058 MD Practitioner - Family Practice 4688838493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237274MAMDFamily Medicine Physician
P1275TXMDFamily Medicine Physician
D74732MDMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2018 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2018 Accepting new patients
Mobile Medical Industries Inc PastSince Jul 31, 2023 Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1861654642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-475-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 SOUTHPOINT DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168007",
            "telephone_number": "904-470-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIONES",
        "first_name": "IVAN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "237274",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1275",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MD",
            "license": "D74732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.