Individual provider Active NPI

Elias Ivan Couto Barbosa, M.D.

  • Hospitalist Physician
  • Jacksonville, FL
National Provider Identifier
1992065163
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME124789 Issued in FL
Practice address
820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205
Phone
(904) 202-3860
Fax
(904) 202-3846
NPI assigned
May 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME124789 FL
Nephrology Physician 207RN0300X 124789 FL
Hospitalist Physician 208M00000X ME124789 FL Primary

Addresses

Primary practice location

820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205

Mailing address

655 West 8TH St.
Acc BLDG, 4TH Floor
Jacksonville, FL 32209
Phone (904) 383-1013

Other practice location 1

655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 383-1013

Other identifiers 1

IdentifierTypeStateIssuer
ME124789OtherFLFLORIDA BOARD OF MEDICINE

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
I20190913001350 FL Practitioner - HospitalistPractitioner - Internal Medicine 6901116565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124789FLMDNephrology Physician
ME124789FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc. Internal Medicine CurrentSince Aug 15, 2019 Accepting new patients
Baptist Primary Care Inc Internal Medicine Current Accepting new patients
Baptist Primary Care Inc CurrentSince Aug 15, 2019 Accepting new patients

Locations

820 Prudential Dr
Ste 304
Jacksonville, FL 32207
Phone (904) 202-3860

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

Interoperability endpoints

  • Direct secure messaging: ecoutobarbosa28369@baptisthealthsystemjacksonville.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1992065163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 WEST 8TH ST.",
            "address_2": "ACC BLDG, 4TH FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32209",
            "telephone_number": "904-383-1013",
            "fax_number": "904-244-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078205",
            "telephone_number": "904-202-3860",
            "fax_number": "904-202-3846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-383-1013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUTO BARBOSA",
        "first_name": "ELIAS",
        "middle_name": "IVAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME124789",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "124789",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME124789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF MEDICINE",
            "identifier": "ME124789",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.