Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1821663782 Individual Practitioner Male Practitioner

Dr. Raphael G Banoub , MD

Ophthalmology • Jacksonville, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Raphael Banoub, MD is a certified Ophthalmology practicing in Jacksonville, FL. With approximately 6 years of clinical experience since graduating from Wayne State University School Of Medicine in 2020, Dr. Banoub delivers high-quality medical care to the local community at 4500 SAN PABLO RD S.

Dr. Banoub is affiliated with Mayo Clinic Jacksonville and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

4500 San Pablo Rd S

Jacksonville, FL 322241865

Telephone 9049532000
Associated Practice Facility / Clinic
🏢 Mayo Clinic Jacksonville Facility NPI 1790772317

Medicare Profile & Education

Medical School

Wayne State University School Of Medicine

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Jacksonville, FL

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -21.4 yrs vs City Avg
City Avg: 27.4 Yrs
State Avg: 28.9 Yrs
Regional Practice Density
89 Specialists

Practicing in Jacksonville, FL (1686 Statewide)

Telehealth Adoption Rate
3.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Banoub (6 Years) 6 Yrs
Jacksonville Specialty Average (27.4 Years) 27.4 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-07-28
Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License FL ME175224

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Hospital & Practice Group Affiliations

Mayo Clinic Jacksonville

4500 San Pablo Rd S, Jacksonville, FL 322241865

Phone: 9049532000

Secondary Practice Locations

1600 S Andrews Ave

Fort Lauderdale, FL 333162510

Phone: 9543554400

27005 76th Ave

New Hyde Park, NY 110401402

Phone: 7184704475

201 E Sample Rd

Deerfield Beach, FL 330643502

Phone: 9549418300

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Katherine Walsh , PA-C, MPH

Physician Assistant

NPI 1003015280

Physician Assistant (Certified), Master of Public Health

Dr. Jami Kinnucan , MD

Internal Medicine - Gastroenterology

NPI 1003045634

Doctor of Medicine (M.D.)

Dr. Glenn Shi , MD

Orthopaedic Surgery

NPI 1003058660

Doctor of Medicine (M.D.)

Dr. Michelle Tulang , MD

Internal Medicine

NPI 1003073586

Doctor of Medicine (M.D.)

NPI 1003100520

Doctor of Medicine (M.D.)

Crystal Lynn , CRNA

Nurse Anesthetist, Certified Registered

NPI 1003148768

Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location July 28, 2025

Registered at 4500 SAN PABLO RD S, JACKSONVILLE, FL 322241865 (Tel: 9049532000)

👤
Provider Name / Credentials Updated July 28, 2025

Recorded as RAPHAEL BANOUB, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 28, 2025

Ophthalmology (License #ME175224 in FL)

📍
Updated Practice Location May 07, 2022

Registered at 1600 S ANDREWS AVE, FORT LAUDERDALE, FL 333162510 (Tel: 9543554400)

NPI Profile Active May 24, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location May 24, 2021

Registered at 27005 76TH AVE, NEW HYDE PARK, NY 110401402 (Tel: 7184704475)

📍
Updated Business Mailing Address May 24, 2021

Registered at 27005 76TH AVE, NEW HYDE PARK, NY 110401402 (Tel: 7184704475)

👤
Provider Name / Credentials Updated May 24, 2021

Recorded as RAPHAEL BANOUB

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 24, 2021

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 24, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1821663782
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2021
Last Update: July 28, 2025
Sole Proprietor: No

Mailing Address

27005 76th Ave

New Hyde Park, NY 110401402

Phone: 7184704475

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.