Mohamed Hisham Antar, MD

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

2150 Park St
Jacksonville, FL 32204-3847

Phone

(904) 384-8733

Fax

(904) 384-9004

NPI assigned

Dec 28, 2005

Last updated

Jul 7, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ackerman Cancer Center, PA

  • Radiation Oncology Physician
  • St Augustine, FL
  • NPI 1750175501
  Medicare reassignment NPD
• Mohamed H Antar MD PA

  • Urology Physician
  • Jacksonville, FL
  • NPI 1225197916
  Authorized official Same address or phone
• Ackerman Cancer Center, P.a.

  • Radiation Oncology Physician
  • Fernandina Beach, FL
  • NPI 1134145659
  NPD

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1972580298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043847",
            "telephone_number": "904-384-8733",
            "fax_number": "904-384-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043847",
            "telephone_number": "904-384-8733",
            "fax_number": "904-384-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTAR",
        "first_name": "MOHAMED",
        "middle_name": "HISHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Lee Ansley III
• Teko Terrell Ansley
• Tosha Ansley
• Cherilyn Anson, BA
• Holly M. Antal, PHD
• Nicole Nicholas Antar
• Stephen Anter
• Anthem Lakes
• Anthony Iselborn, DC PA (Iselborn Chiropractic & Sports Medicine)
• Anthony J Potochick OD PA (5 Points Eye Associates)

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.