Individual provider Active NPI

Anthony Nioso, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1912979055
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME71438 Issued in FL
Practice address
10898 Baymeadows Rd Ste 300
Credentialing Department
Jacksonville, FL 32256-5838
Phone
(904) 363-2733
Fax
(904) 363-3484
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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 ME71438 FL Primary

Addresses

Primary practice location

10898 Baymeadows Rd Ste 300
Credentialing Department
Jacksonville, FL 32256-5838

Mailing address

PO Box 45443
Salt Lake City, UT 84145-0443
Phone (904) 202-1032

Other identifiers 1

IdentifierTypeStateIssuer
P00092786OtherFLRR MEDICARE

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
I20040626000027 FL Practitioner - Family Practice 1254317639 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Family Medicine CurrentSince Mar 1, 2004 Accepting new patients
Baptist Primary Care Inc Family Medicine CurrentSince Mar 1, 2004 Accepting new patients
VMD Primary Providers Central Florida PLLC Family Medicine CurrentSince Feb 7, 2022 Accepting new patients
Baptist Primary Care Inc Family Medicine Current Accepting new patients
VMD Primary Providers Central Florida PLLC Family Medicine PastSince May 8, 2022 Accepting new patients

Locations

4404 S Highway 27
Clermont, FL 34711

10898 Baymeadows Rd
Ste 300
Jacksonville, FL 32256
Phone (904) 363-2733

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

4237 Salisbury Rd
Ste 302
Jacksonville, FL 32216
Phone (904) 296-6884

210 Southern Breeze Dr
Minneola, FL 34715

1060 Woodcock Rd
Ste 128
Orlando, FL 32803
Phone (346) 980-2725

Interoperability endpoints

  • Direct secure messaging: anthony.nioso.1@31396.direct.athenahealth.com

Organizations & group practices 5

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1912979055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10898 BAYMEADOWS RD STE 300",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565838",
            "telephone_number": "904-363-2733",
            "fax_number": "904-363-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIOSO",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME71438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00092786",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.