BAPTIST-SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES INC (NPI# 1083153365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083153365 |
| Entity Type | Organization |
| Organization Name | BAPTIST-SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES INC |
| Other Organization Name | BAPTIST MD ANDERSON CANCER PHYSICIANS |
| Practice Address |
14540 Old Saint Augustine Rd Suite 2593 Jacksonville FL 32258-7418 |
| Mailing Address |
Po Box 45278 Jacksonville FL 32232-5278 |
| Practice Telephone | 9043893993 |
| Practice Fax Number | 9043893994 |
| Mailing Telephone | 9042022092 |
| Mailing Fax Number | 9043937603 |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |
| Authorized Official Name | LEEANN MENGEL (ADMINISTRATOR) |
| Authorized Official Telephone | 9042027300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 009942200 | 05 | |
| FL | RR MEDICARE | DU3570 | 01 |
| Other Name | Type Code |
|---|---|
| Baptist MD Anderson Cancer Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568941276 | Baptist-southeast Gynecologic Oncology Associates Inc | Internal Medicine | 1301 Palm Ave, Jacksonville, FL 32207 | 2018-08-13 |
| 1477032183 | Baptist-southeast Gynecologic Oncology Associates Inc | Radiology | 14546 Old Saint Augustine Rd Ste 105, Jacksonville, FL 32258-5469 | 2018-08-13 |
| 1558840264 | Baptist-southeast Gynecologic Oncology Associates Inc | Internal Medicine | 14546 Old Saint Augustine Rd Ste 100, Jacksonville, FL 32258-5468 | 2018-08-13 |
| Street Address |
14540 OLD SAINT AUGUSTINE RD SUITE 2593 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32258-7418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124023445 | John Michael Tierney | Physician Assistant | 14540 Old Saint Augustine Rd, Suite 2201, Jacksonville, FL 32258-7418 | 2005-06-14 |
| 1760851521 | Lindsay Choate | Physician Assistant | 14540 Old Saint Augustine Rd, Suite 2317, Jacksonville, FL 32258-7418 | 2015-09-22 |
| 1639505035 | Baptist Neurology Inc | Psychiatry & Neurology | 14540 Old Saint Augustine Rd, Suite 2599, Jacksonville, FL 32258-7418 | 2013-09-18 |
| 1275975047 | Christi Burnett Paul | Nurse Practitioner | 14540 Old Saint Augustine Rd, Suite 2207, Jacksonville, FL 32258-7418 | 2013-07-22 |
| 1215378203 | Alana Michelle Weatherly | Physician Assistant | 14540 Old Saint Augustine Rd, Suite 2391, Jacksonville, FL 32258-7418 | 2013-07-08 |
| 1801150594 | Matthew Theodore Swiatowicz | Physician Assistant | 14540 Old Saint Augustine Rd, Suite 2317, Jacksonville, FL 32258-7418 | 2012-06-27 |
| 1215233184 | Sunshine Spine and Pain Pa | Specialist | 14540 Old Saint Augustine Rd, Mob 2 Suite 2397, Jacksonville, FL 32258-7418 | 2011-02-09 |
| 1679802904 | Baptist Primary Care Inc | Internal Medicine | 14540 Old Saint Augustine Rd, Suite 2307, Jacksonville, FL 32258-2460 | 2009-12-16 |
| 1851530216 | Alyssa A Paetau | Surgery | 14540 Old Saint Augustine Rd, Suite 2571, Jacksonville, FL 32258-7418 | 2009-02-09 |
| 1205080652 | Cameron David Adkisson | Surgery | 14540 Old Saint Augustine Rd, 2571, Jacksonville, FL 32258-7418 | 2008-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794237 | Nicoleta Descalzo | Behavior Technician | 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 | 2019-11-15 |
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| 1679013932 | Optometry Vision Care Pllc | Optometrist | 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 | 2017-03-06 |
| 1467991950 | North Florida Vision Group Inc | Optometrist | 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 | 2017-02-16 |
| 1124576566 | Revolution Chiropractic LLC | Chiropractor | 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-14 |
| 1396291936 | Robyn Reaves | Nurse Practitioner | 12361 Richards Glen Ct, Jacksonville, FL 32258 | 2016-09-01 |
| 1326595927 | Lauren Cost | Chiropractor | 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-01 |
| 1487991170 | Mark Steven Colosimo | Pharmacist | 13820 Old St Augustine Road, Jacksonville, FL 32258 | 2013-01-15 |
| Find all providers in zip 32258 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114527132 | Sarah Sowinski | Obstetrics & Gynecology | 4203 Belfort Rd Ste 204, Jacksonville, FL 32216-1463 | 2020-10-28 |
| 1639438088 | Isidore Daniel Benrubi | Obstetrics & Gynecology | 655 W 8th St, Jacksonville, FL 32209-6511 | 2012-05-04 |
| 1811105372 | Jenny Whitworth | Obstetrics & Gynecology | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2007-05-18 |
| 1619986932 | Tri Dinh | Obstetrics & Gynecology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2006-08-05 |
| 1396794681 | Stephen Leslie Buckley | Obstetrics & Gynecology | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2006-05-06 |
| 1689622284 | Matthew W Robertson IIi | Obstetrics & Gynecology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2006-05-05 |
| 1417905993 | Southeast Gynecologic Oncology Associates Pa | Obstetrics & Gynecology | 915 W Monroe St, #300, Jacksonville, FL 32204-1149 | 2006-05-05 |
| 1962495036 | Karl H.s. Smith | Obstetrics & Gynecology | 655 W 8th St, University of Florida Center for Women, Jacksonville, FL 32209-6511 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1851738793 | Christopher De Haydu | Obstetrics & Gynecology | 1121 Nw 14th St Dept Gyn, Miami, FL 33136-2106 | 2013-06-02 |
| 1811330897 | Maria Paula Ruiz | Obstetrics & Gynecology | 6400 W Newberry Rd Ste 103, Gainesville, FL 32605-4384 | 2013-04-09 |
| 1992005086 | Jocelyn Garcia-sayre | Obstetrics & Gynecology | 5000 University Dr Ste 3300, Coral Gables, FL 33146-2008 | 2010-10-24 |
| 1063641827 | Kenneth Daniel Webster | Obstetrics & Gynecology | 3825 Sw 86th St., Gainesville, FL 32608-7901 | 2009-07-14 |
| 1942444526 | Mostafa A Selim | Obstetrics & Gynecology | 338 Wellington Dr., Palm Coast, FL 32164 | 2009-04-27 |
| 1063670255 | Women's Choice Oncology, Pllc | Obstetrics & Gynecology | 3425 University Parkway Unit 102, Sarasota, FL 34243 | 2008-05-25 |
| 1912197641 | Gyn Oncology Associates Pl | Obstetrics & Gynecology | 2617 Mitcham Dr Ste 101, Tallahassee, FL 32308-5479 | 2007-07-30 |
| 1336368547 | Stacey Ann South | Obstetrics & Gynecology | 3425 University Pkwy Unit 102, Sarasota, FL 34243-4271 | 2007-04-25 |
| 1982766044 | Philip Townsend Md Pa | Obstetrics & Gynecology | 675 Harvard St, Brooksville, FL 34601-2823 | 2006-12-15 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32258 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.