Active NPI
Michael Stuart Drucker, M.D.
- Family Medicine Physician
- Jacksonville, FL
National Provider Identifier
1922063106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME0026676
- Practice address
- 8837 Goodbys Executive Dr
Jacksonville, FL 32217-4695 - Phone
- (904) 731-7650
- Fax
- (904) 448-0370
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME0026676 | FL | Primary |
Addresses
Primary practice location
8837 Goodbys Executive Dr
Jacksonville, FL 32217-4695
Mailing address
8837 Goodbys Executive Dr
Jacksonville, FL 32217-4695
Phone (904) 731-7650
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000581200 | Medicaid | FL | |
| P00649332 | Other | FL | MEDICARE RR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0026676 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237334400000",
"number": "1922063106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8837 GOODBYS EXECUTIVE DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322174695",
"telephone_number": "904-731-7650",
"fax_number": "904-448-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8837 GOODBYS EXECUTIVE DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322174695",
"telephone_number": "904-731-7650",
"fax_number": "904-448-0370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRUCKER",
"first_name": "MICHAEL",
"middle_name": "STUART",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2009-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME0026676",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000581200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P00649332",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.