| Dr Chonglun Xie, MD | |
|
5757 Booth Rd, Suite 200, Jacksonville, FL 32207-5980 | |
| (904) 636-9510 | |
| (904) 636-9512 |
| Full Name | Dr Chonglun Xie |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 40 Years |
| Location | 5757 Booth Rd, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861457459 | NPI | - | NPPES |
| 7245685 | Other | FL | AETNA |
| 16175 | Other | FL | BCBS |
| 2574641 | Other | UNITED HEALTH CARE | |
| 27393819 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME92689 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Florida First Care Inc | Orange park, FL | Home health agency |
| Memorial Hospital Jacksonville | Jacksonville, FL | Hospital |
| Mayo Clinic Florida | Jacksonville, FL | Hospital |
| Ascension St Vincent's Riverside | Jacksonville, FL | Hospital |
| University Crossing | Jacksonville, FL | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Physical Medicine Specialists, Inc | 1658335328 | 56 |
| Lighthouse Internal Medicine And Primary Care Pa | 9234232224 | 3 |
| Entity Name | Physical Medicine Specialists, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952343261 PECOS PAC ID: 1658335328 Enrollment ID: O20041113000028 |
| Entity Name | Lighthouse Internal Medicine And Primary Care Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588742977 PECOS PAC ID: 9234232224 Enrollment ID: O20070313000010 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Chonglun Xie, MD 5757 Booth Rd, Suite 200, Jacksonville, FL 32207-5980 Ph: (904) 636-9510 | Dr Chonglun Xie, MD 5757 Booth Rd, Suite 200, Jacksonville, FL 32207-5980 Ph: (904) 636-9510 |
Dr. Jami Ann Rothe Kinnucan, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Michelle Tulang, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Dr. Minnsun Koh Park, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3900 University Blvd S, Jacksonville, FL 32216 Phone: 904-222-6656 | |
Sandrela Mussallam Abu Shaibeh, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 820 Prudential Dr Ste 304, Jacksonville, FL 32207 Phone: 904-202-3860 Fax: 904-202-3846 | |
Krunal Patel, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4800 Belfort Rd, Jacksonville, FL 32256 Phone: 904-398-7205 Fax: 904-396-4047 | |
Zaid Abdel Rahman, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Sina O'sullivan, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |