| Baptist Md Anderson Cancer Physicians | |
|
1235 San Marco Blvd Suite 2 Jacksonville FL 32207-8554 | |
| (904) 202-7300 | |
| (904) 202-7377 |
| Full Name | Baptist Md Anderson Cancer Physicians |
|---|---|
| Speciality | Internal Medicine |
| Location | 1235 San Marco Blvd, Jacksonville, Florida |
| Authorized Official Name and Position | Leeann Mengel (VICE PRESIDENT) |
| Authorized Official Contact | 9042027300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Md Anderson Cancer Physicians Po Box 746654 Atlanta GA 30374-6654 Ph: (904) 202-2092 | Baptist Md Anderson Cancer Physicians 1235 San Marco Blvd Suite 2 Jacksonville FL 32207-8554 Ph: (904) 202-7300 |
| NPI Number | 1538593124 |
|---|---|
| Provider Enumeration Date | 08/30/2013 |
| Last Update Date | 04/10/2023 |
| Medicare PECOS PAC ID | 5991932063 |
|---|---|
| Medicare Enrollment ID | O20131217000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538593124 | NPI | - | NPPES |
| DU3570 | Other | FL | RAILROAD MEDICARE |
| 003149978A | Medicaid | GA | |
| 0099422-00 | Medicaid | FL |
| Provider Name | Stephen L Buckley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396794681 PECOS PAC ID: 8224920020 Enrollment ID: I20040326000699 |
| Provider Name | Neenad M Shah |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1922000751 PECOS PAC ID: 1254392772 Enrollment ID: I20041019000769 |
| Provider Name | Mark Augspurger |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1689630949 PECOS PAC ID: 2961469275 Enrollment ID: I20050208000464 |
| Provider Name | Jorge Antunez De Mayolo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1407844798 PECOS PAC ID: 8729054788 Enrollment ID: I20050705000652 |
| Provider Name | Eric Sauvageau |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1346252814 PECOS PAC ID: 7214939735 Enrollment ID: I20070212000505 |
| Provider Name | Ricardo A Hanel |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356394936 PECOS PAC ID: 0941251128 Enrollment ID: I20071018000318 |
| Provider Name | Cynthia S Anderson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1174724819 PECOS PAC ID: 0547359804 Enrollment ID: I20071210000291 |
| Provider Name | Laila Samiian |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1760663124 PECOS PAC ID: 1951489160 Enrollment ID: I20080428000628 |
| Provider Name | Sridhar Srinivasan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750598363 PECOS PAC ID: 4385718634 Enrollment ID: I20080804000653 |
| Provider Name | Cherri J Rosimini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801802889 PECOS PAC ID: 9537235874 Enrollment ID: I20080910000182 |
| Provider Name | Paul W Nowicki |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1255382982 PECOS PAC ID: 3375550320 Enrollment ID: I20080924000179 |
| Provider Name | Ron Landmann |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1407013592 PECOS PAC ID: 2860550548 Enrollment ID: I20081024000185 |
| Provider Name | Michael Olson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1427244037 PECOS PAC ID: 7113078197 Enrollment ID: I20090702000408 |
| Provider Name | Robert Zaiden |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1821143710 PECOS PAC ID: 2769529155 Enrollment ID: I20091016000006 |
| Provider Name | Maxim Norkin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1841428588 PECOS PAC ID: 1153447958 Enrollment ID: I20100929001259 |
| Provider Name | Dat C Pham |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659332831 PECOS PAC ID: 7012191380 Enrollment ID: I20110411000612 |
| Provider Name | Omar M Mahmoud |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1467784439 PECOS PAC ID: 7214108810 Enrollment ID: I20110912000138 |
| Provider Name | Lara Z Zuberi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750342457 PECOS PAC ID: 2466488325 Enrollment ID: I20120724000061 |
| Provider Name | Jenny M Whitworth |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1811105372 PECOS PAC ID: 2860553625 Enrollment ID: I20130807000964 |
| Provider Name | Angela I Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396176111 PECOS PAC ID: 2961631056 Enrollment ID: I20140213000464 |
| Provider Name | Nancy Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417180076 PECOS PAC ID: 2466618491 Enrollment ID: I20140822000918 |
| Provider Name | William A Hammond |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1932426590 PECOS PAC ID: 8820239288 Enrollment ID: I20140827000573 |
| Provider Name | John Vu |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1497956072 PECOS PAC ID: 7315193067 Enrollment ID: I20150730013645 |
| Provider Name | Edward Gorak |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376580696 PECOS PAC ID: 5193737955 Enrollment ID: I20150803002240 |
| Provider Name | Robert Cavaliere |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730263096 PECOS PAC ID: 5395779516 Enrollment ID: I20150929002827 |
| Provider Name | Jonathan J Melquist |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336396910 PECOS PAC ID: 3476777996 Enrollment ID: I20151022002623 |
| Provider Name | Joe Putnam |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1073600193 PECOS PAC ID: 5991791261 Enrollment ID: I20151102001903 |
| Provider Name | Michele L Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346621992 PECOS PAC ID: 7214231315 Enrollment ID: I20160210001922 |
| Provider Name | Wassim Samra |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780947754 PECOS PAC ID: 1153610555 Enrollment ID: I20160524000749 |
| Provider Name | Julie C Greenwalt |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1649562463 PECOS PAC ID: 7214171297 Enrollment ID: I20160616002490 |
| Provider Name | Sarah R Griffis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174970701 PECOS PAC ID: 8022300631 Enrollment ID: I20160629003084 |
| Provider Name | Kathleen F Fort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205381571 PECOS PAC ID: 0042508525 Enrollment ID: I20161017001029 |
| Provider Name | Allison H Courson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295285781 PECOS PAC ID: 5799066056 Enrollment ID: I20161227001969 |
| Provider Name | Christopher M Pezzi |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1326123662 PECOS PAC ID: 5193790459 Enrollment ID: I20170121000262 |
| Provider Name | Diana E Amenya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396281028 PECOS PAC ID: 5294005096 Enrollment ID: I20170727001790 |
| Provider Name | Patrick Alan Regis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659852325 PECOS PAC ID: 7719239292 Enrollment ID: I20181010003693 |
| Provider Name | Leslie Shannan Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770059008 PECOS PAC ID: 6103160239 Enrollment ID: I20181130001035 |
| Provider Name | Jacquelene Marie Carson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710456215 PECOS PAC ID: 6002151073 Enrollment ID: I20181219001105 |
| Provider Name | Faisal Iftikhar Ahmad |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770859944 PECOS PAC ID: 3476799859 Enrollment ID: I20190613001715 |
| Provider Name | Jessica C Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972167740 PECOS PAC ID: 3173857414 Enrollment ID: I20190620001782 |
| Provider Name | Barrett Zachary Mccormick |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235495003 PECOS PAC ID: 8921373259 Enrollment ID: I20190802002819 |
| Provider Name | Aakash M Modi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1043573769 PECOS PAC ID: 3678804580 Enrollment ID: I20191008000782 |
| Provider Name | Subrato Jesse Deb |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1548240765 PECOS PAC ID: 7113007600 Enrollment ID: I20191030000339 |
| Provider Name | Heather Harper Augustyniak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386080364 PECOS PAC ID: 2163656307 Enrollment ID: I20191220001749 |
| Provider Name | Lillie Emmelhainz O'steen |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1942680707 PECOS PAC ID: 0345557062 Enrollment ID: I20200622001458 |
| Provider Name | Kimberly Nguyen Blythe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669096897 PECOS PAC ID: 3678995297 Enrollment ID: I20200626000947 |
| Provider Name | Leslie Gayle Lohse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831716547 PECOS PAC ID: 3274958749 Enrollment ID: I20200730002326 |
| Provider Name | Bharatsinh Gharia |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1700242187 PECOS PAC ID: 6608161773 Enrollment ID: I20200731001536 |
| Provider Name | Lauren Cooper Hand |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1164866778 PECOS PAC ID: 9335372036 Enrollment ID: I20200813003616 |
| Provider Name | Lael S Stieglitz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336535004 PECOS PAC ID: 9032416557 Enrollment ID: I20200916000468 |
| Provider Name | Niraj Jaysukh Gusani |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1326154907 PECOS PAC ID: 2668470279 Enrollment ID: I20201016002593 |
| Provider Name | Robert J Wilson |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1649560814 PECOS PAC ID: 3779886304 Enrollment ID: I20201111001041 |
| Provider Name | Geetika Bhatt |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1205193349 PECOS PAC ID: 0648570531 Enrollment ID: I20201117000585 |
| Provider Name | Cindy Goodrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518597186 PECOS PAC ID: 4183051279 Enrollment ID: I20210122002420 |
| Provider Name | Amy Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144839861 PECOS PAC ID: 7810396322 Enrollment ID: I20210602002636 |
| Provider Name | Karen Beatrice Ching-tismal |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1548454259 PECOS PAC ID: 7416113808 Enrollment ID: I20210616001788 |
| Provider Name | Konstantinos Chouliaras |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1215349022 PECOS PAC ID: 5991016149 Enrollment ID: I20210721002840 |
| Provider Name | Erica Mayland |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871980987 PECOS PAC ID: 6103247523 Enrollment ID: I20210810004171 |
| Provider Name | Candace Michele Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518530427 PECOS PAC ID: 3870999535 Enrollment ID: I20210902003381 |
| Provider Name | Cathryn Mcgill Johnson |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1376987289 PECOS PAC ID: 5991946238 Enrollment ID: I20210909002928 |
| Provider Name | Tamara Goda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548455850 PECOS PAC ID: 7315018652 Enrollment ID: I20211217001834 |
| Provider Name | Callie Leigh-anne Soltero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972257574 PECOS PAC ID: 6800282047 Enrollment ID: I20220415000188 |
| Provider Name | Avani Changela |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740582246 PECOS PAC ID: 6901118140 Enrollment ID: I20220524001535 |
| Provider Name | Nadiene Ann Stock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083984306 PECOS PAC ID: 6608039482 Enrollment ID: I20220730000174 |
| Provider Name | Kathleen Marie Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184354615 PECOS PAC ID: 8022484831 Enrollment ID: I20221019002544 |
| Provider Name | April E Reagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043330475 PECOS PAC ID: 8628174349 Enrollment ID: I20221117002314 |
| Provider Name | Dayra C Avila Lima |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679881502 PECOS PAC ID: 2668777962 Enrollment ID: I20221213000625 |
| Provider Name | Kerwin K Cumberbatch |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1669785788 PECOS PAC ID: 9931478971 Enrollment ID: I20230218000510 |
| Provider Name | Ian G Pinto |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1245265057 PECOS PAC ID: 7315940087 Enrollment ID: I20230327002027 |
| Provider Name | Mona Janfaza |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1215283015 PECOS PAC ID: 2466766142 Enrollment ID: I20230411000006 |
| Provider Name | Alexandria Darles Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639877848 PECOS PAC ID: 5597120030 Enrollment ID: I20230505000240 |
| Provider Name | Hind Mamdouh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902508351 PECOS PAC ID: 0446616908 Enrollment ID: I20230525002431 |
| Provider Name | Blaine Daniel Smith |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1568996775 PECOS PAC ID: 7416339544 Enrollment ID: I20230718000031 |
| Provider Name | Arian Majko |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1578902755 PECOS PAC ID: 3476843673 Enrollment ID: I20230731001837 |
| Provider Name | David Jeffrey Hall |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1700224110 PECOS PAC ID: 7911135090 Enrollment ID: I20230807000371 |
| Provider Name | Krista N Zodarecky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932640802 PECOS PAC ID: 8820367550 Enrollment ID: I20240119001618 |
| Provider Name | Tomislav Dragovich |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518979715 PECOS PAC ID: 3476681578 Enrollment ID: I20240312000526 |
Lem Turner Family Medical Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9390 Lem Turner Rd, Jacksonville, FL 32208 Phone: 904-766-2953 Fax: 904-766-2993 | |
C. Surgery Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 532 Riverside Ave, Jacksonville, FL 32202 Phone: 904-791-6632 | |
Centerwell Senior Primary Care Fl Jv Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4250 Philips Hwy, Jacksonville, FL 32207 Phone: 407-447-7120 | |
Id Associates Of Jacksonville Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Shircliff Way, Ste 610, Jacksonville, FL 32204 Phone: 904-387-5027 Fax: 904-387-2208 | |
Hong Tek Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4123 University Blvd S, Jacksonville, FL 32216 Phone: 904-388-3351 | |
Baptist Primary Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 532 Riverside Ave Ste 103, Jacksonville, FL 32202 Phone: 904-353-5696 Fax: 904-390-7483 | |
Reginald L. Sykes, Sr, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3160 Edgewood Ave W, Jacksonville, FL 32209 Phone: 904-768-8222 Fax: 904-482-0373 |