Individual provider Active NPI

Michael Hanson Carpenter

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1992209852
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
TRN26678 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-3817
Fax
(904) 244-5848
NPI assigned
Mar 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TRN26678 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

655 W 8TH St # C506
Jacksonville, FL 32209-6511
Phone (904) 244-3817

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
I20210406000880 FL Practitioner - Emergency Medicine 9335484864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Florida College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, shared by 5 NPIs, 908 clinicians

Practice addresses (Care Compare)

15255 Max Leggett Pkwy
Jacksonville, FL 32218-7213
Phone (904) 383-1000

653 W 8TH St
Jacksonville, FL 32209-6511

655 W 8TH St
Jacksonville, FL 32209-6511

655 W 8TH St
Jacksonville, FL 32231-6511
Phone (904) 244-6340

76011 William Burgess Rd
Yulee, FL 32097-5428
Phone (904) 427-8590

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN26678FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince May 1, 2021 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince May 1, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince May 29, 2021 Accepting new patients
University of Florida Jacksonville Physicians Inc Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

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

655 W 8th St
#C506
Jacksonville, FL 32209
Phone (904) 244-3817

Interoperability endpoints

  • Direct secure messaging: mcarpenter211697@direct.shands.ufl.edu

Organizations & group practices 5

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 2

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1992209852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST # C506",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3817",
            "fax_number": "904-244-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3817",
            "fax_number": "904-244-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "MICHAEL",
        "middle_name": "HANSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "TRN26678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.