Individual provider Active NPI

Nasrullah Ghafoor, MD

  • Hospitalist Physician
  • Jacksonville, FL
National Provider Identifier
1972585081
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME68887 Issued in FL
Practice address
4466 Swilcan Bridge LN N
Jacksonville, FL 32224-5617
Phone
(904) 281-0944
Fax
(904) 281-9806
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME68887 FL Primary

Addresses

Primary practice location

4466 Swilcan Bridge LN N
Jacksonville, FL 32224-5617

Mailing address

4466 Swilcan Bridge LN N
Jacksonville, FL 32224-5617
Phone (904) 281-0944

Other identifiers 1

IdentifierTypeStateIssuer
253275100MedicaidFL

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
I20040916000564 FL Practitioner - HospitalistPractitioner - Internal Medicine 5698742641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 281-0944

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME68887FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Specialists Current Accepting new patients
Hospital Specialists Inc CurrentSince Jul 1, 2004 Accepting new patients
Southern Medical Clinic PA Past Accepting new patients

Locations

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

9838 Old Baymeadows Rd
Jacksonville, FL 32256
Phone (904) 472-0537

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1972585081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4466 SWILCAN BRIDGE LN N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322245617",
            "telephone_number": "904-281-0944",
            "fax_number": "904-281-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 SWILCAN BRIDGE LN N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322245617",
            "telephone_number": "904-281-0944",
            "fax_number": "904-281-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAFOOR",
        "first_name": "NASRULLAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME68887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253275100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.