Individual provider Active NPI

Mark M Carter, M.D.

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1932128337
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME47719 Issued in FL
Practice address
4521 Shiloh Mill Blvd
Jacksonville, FL 32246-1880
Phone
(904) 699-4337
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD421030 PA
Diagnostic Radiology Physician 2085R0202X ME47719 FL Primary

Addresses

Primary practice location

4521 Shiloh Mill Blvd
Jacksonville, FL 32246-1880

Mailing address

4521 Shiloh Mill Blvd
Jacksonville, FL 32246
Phone (904) 699-4337

Other identifiers 1

IdentifierTypeStateIssuer
061625700MedicaidFL

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
I20071204000118 FL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 4688638539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Florida College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 398-7205

836 Prudential Dr
Suite 801
Jacksonville, FL 32207-8335
Phone (904) 288-0433

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
69.69
Promoting interoperability
89
Improvement activities
40
Cost
69.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME47719FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Borland Groover Clinic, PA Diagnostic Radiology CurrentSince Jun 15, 2007 Accepting new patients
Frank Olney & Rudy Nicolas PTRS Diagnostic Radiology PastSince Oct 15, 2008 Accepting new patients

Locations

836 Prudential Dr
Ste 801
Jacksonville, FL 32207
Phone (904) 288-0433

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1932128337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 SHILOH MILL BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32246",
            "telephone_number": "904-699-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 SHILOH MILL BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322461880",
            "telephone_number": "904-699-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD421030",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME47719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061625700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.