NPIMap

Individual provider Active NPI

Jose Raphael G Tamayo, MD

  • Family Medicine Physician
  • Jacksonville Beach, FL
National Provider Identifier
1912161340
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 108621 Issued in FL
Practice address
1127 16TH Ave S # 216
Jacksonville Beach, FL 32250-3213
Phone
(904) 247-7778
Fax
(904) 390-7389
NPI assigned
Jul 15, 2008
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 108621 FL Primary

Addresses

Primary practice location

1127 16TH Ave S # 216
Jacksonville Beach, FL 32250-3213

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092

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
I20110810000634 FL Practitioner - Family Practice 3678742582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

1 Fleet Landing Blvd
Atlantic Beach, FL 32233-4599
Phone 90424699001433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 108621FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Dec 1, 2017 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients
Baptist Primary Care Inc. Family Medicine CurrentSince Dec 1, 2017 Accepting new patients

Locations

1 Fleet Landing Blvd
Jacksonville, FL 32233
Phone (904) 246-9900

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

1127 16th Ave S
Jax Bch, FL 32250
Phone (904) 247-7778

1370 13th Ave S
Ste 216
Jax Bch, FL 32250
Phone (904) 246-8480

900 Beach Blvd
Jax Bch, FL 32250
Phone (904) 249-0335

Interoperability endpoints

  • Direct secure messaging: jtamayo28240@baptisthealthsystemjacksonville.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1912161340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 16TH AVE S # 216",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503213",
            "telephone_number": "904-247-7778",
            "fax_number": "904-390-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO",
        "first_name": "JOSE RAPHAEL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 108621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.