FADY MAGDY SHOUKRY BOTROUS DO
NPI 1104628858
Internal Medicine in Jacksonville, FL

Active since March 25, 2025PECOS Enrolled
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 24, 2025, Mar 25, 2025 (2 updates tracked since 2025).

About Fady Magdy Shoukry Botrous Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FADY MAGDY SHOUKRY BOTROUS DO (NPI 1104628858) is an individual internal medicine provider in Jacksonville, Florida, licensed in Florida (UO10478) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104628858
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameFADY MAGDY SHOUKRY BOTROUSCredential: DO
Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865
Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (904) 953-2000
Sole ProprietorNo
Enumeration DateMarch 25, 2025
Last NPPES UpdateJune 24, 20252 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
NPI 1104628858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in FL · UO10478
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4500 SAN PABLO RD S, Jacksonville, FL 32224

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Fady Magdy Shoukry Botrous Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Internal Medicine (Gastroenterology)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Orthopaedic Surgery
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Internal Medicine
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Hospitalist
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fady Botrous's NPI number?

The NPI number for Fady Botrous is 1104628858. It was assigned to this individual provider in the NPPES registry on March 25, 2025.

Where is Fady Botrous located?

Fady Botrous practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.

What is Fady Botrous's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Fady Botrous enrolled in Medicare?

Yes. Fady Botrous is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Fady Botrous was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.