Individual provider Active NPI

Jennifer Susanne Babjak, MD

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1972347326
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TRN40932 Issued in FL
Practice address
201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Phone
(386) 425-4165
Fax
(386) 425-7545
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 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 TRN40932 FL Primary

Addresses

Primary practice location

201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765

Mailing address

201 N Clyde Morris Blvd Ste 200
Daytona Beach, FL 32114-2765
Phone (386) 425-4165

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
I20240711002156 FL Order and Referring Only - Family PracticePractitioner - Family Practice 6204371453

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

303 N Clyde Morris Blvd
Daytona BCH, FL 32114-2709

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jennifer.babjak.1@16462.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1972347326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142765",
            "telephone_number": "386-425-4165",
            "fax_number": "386-425-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142765",
            "telephone_number": "386-425-4165",
            "fax_number": "386-425-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABJAK",
        "first_name": "JENNIFER",
        "middle_name": "SUSANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN40932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.