Individual provider Active NPI

Jordan Bilezikian, MD

  • Plastic Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1972967123
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME165369 Issued in FL
Practice address
4147 Southpoint Dr E
Jacksonville, FL 32216-0996
Phone
(904) 425-1846
NPI assigned
Apr 13, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME165369 FL Primary

Addresses

Primary practice location

4147 Southpoint Dr E
Jacksonville, FL 32216-0996

Mailing address

4147 Southpoint Dr E
Jacksonville, FL 32216-0996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230325000082 TN Practitioner - General Surgery 8527359090 Reassigns benefits to 1 organization
I20240612003114 FL Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 8527359090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
Florida State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Cosmetic Center PAGroup PAC ID 1153330931, 2 clinicians

Practice addresses (Care Compare)

4147 Southpoint Dr E
Jacksonville, FL 32216-0996
Phone (904) 332-6774

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME165369FLMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Cosmetic Center, PA Plastic Surgery CurrentSince Aug 1, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Dec 16, 2022 Accepting new patients

Locations

4147 Southpoint Dr E
Jacksonville, FL 32216
Phone (904) 332-6774

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1972967123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4147 SOUTHPOINT DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4147 SOUTHPOINT DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160996",
            "telephone_number": "904-425-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILEZIKIAN",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME165369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.