Individual provider Active NPI

Jean-Claude Desmangles, M.D.

  • Pediatric Endocrinology Physician
  • Pensacola, FL
National Provider Identifier
1992810048
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME128277 Issued in FL
Practice address
5153 N 9TH Ave
Pensacola, FL 32504-8785
Phone
(850) 505-4700
Fax
(850) 505-4711
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 21660 NE
Pediatric Endocrinology Physician 2080P0205X ME128277 FL Primary

Addresses

Primary practice location

5153 N 9TH Ave
Pensacola, FL 32504-8785

Mailing address

10140 Centurion Pkwy N
Provider Enrollment Department
Jacksonville, FL 32256-0532
Phone (904) 697-4127

Other identifiers 2

IdentifierTypeStateIssuer
018049900MedicaidFL
03920445MedicaidNY

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
I20170620000802 FL Practitioner - Endocrinology 5799906012 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21660NEMDPediatrics Physician
ME128277FLMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Apr 15, 2017 Accepting new patients
The Nemours Foundation CurrentSince Apr 15, 2017 Accepting new patients

Locations

3120 Southride Ln
Bonifay, FL 32425
Phone (850) 547-4440

922 Mar Walt Dr
Ste 100
Ft Walton Bch, FL 32547
Phone (850) 226-4785

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

2202 State Ave
Panama City, FL 32405
Phone (850) 785-1401

8331 N Davis Hwy
Pensacola, FL 32514
Phone (850) 505-4700

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

5153 N 9th Ave
Pensacola, FL 32504
Phone (850) 416-1575

9400 University Pkwy
Pensacola, FL 32514
Phone (850) 208-6000

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

1040 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-6555

Interoperability endpoints

  • Direct secure messaging: jdesmangle62730@direct.nemours.org

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992810048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-4127",
            "fax_number": "904-697-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048785",
            "telephone_number": "850-505-4700",
            "fax_number": "850-505-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESMANGLES",
        "first_name": "JEAN-CLAUDE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "21660",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME128277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018049900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03920445",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.