Dr Hani Issa, MD is a medicare enrolled "Internal Medicine - Geriatric Medicine" physician in Penny Farms, Florida. He graduated from medical school in 2004 and has 20 years of diverse experience with area of expertise as Geriatric Medicine. His current practice location is
2 Pavillon Place, Penny Farms, Florida. You can reach out to his office (for appointments etc.) via phone at
(904) 388-3351.
Dr Hani Issa is licensed to practice in Florida (license number ME133628) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1619144045.
Physician's Profile
| Full Name | Dr Hani Issa |
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| Gender | Male |
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| Speciality | Geriatric Medicine |
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| Experience | 20 Years |
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| Location | 2 Pavillon Place, Penny Farms, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Hani Issa graduated from medical school in 2004
NPI Data:
- NPI Number: 1619144045
- Provider Enumeration Date: 05/14/2008
- Last Update Date: 08/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 2668621236
- Enrollment ID: I20170928001398
Medical Identifiers
Medical identifiers for Dr Hani Issa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619144045 | NPI | - | NPPES |
| ME133628 | Other | FL | MEDICAL LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 125050623 (Illinois) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | ME133628 (Florida) | Primary |
| 207R00000X | Internal Medicine | ME133628 (Florida) | Secondary |
Medical Facilities Affiliation
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Hani Issa allows following entities to bill medicare on his behalf.
| Entity Name | St Vincent's Ambulatory Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417987124
PECOS PAC ID: 2860411188
Enrollment ID: O20051116000430 |
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| Entity Name | Issa Med Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376217364
PECOS PAC ID: 8628472537
Enrollment ID: O20210813000780 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Hani Issa is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Hani Issa, MD
1907 Atlantic Blvd,
Jacksonville, FL 32207-3405
Ph: (043) 883-3519 | Dr Hani Issa, MD
2 Pavillon Place,
Penny Farms, FL 32079
Ph: (904) 388-3351 |
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