Ghassan J Ghata, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME0026102 Issued in FL

Practice address

13770 Beach Blvd
Suit 6
Jacksonville, FL 32224-7205

Phone

(904) 330-0524

Fax

(904) 647-9491

NPI assigned

Feb 28, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Afc Florida, LLC

  • Urgent Care Clinic/Center
  • Pace, FL
  • NPI 1205268208
  Medicare reassignment NPD
• Solantic of Jacksonville, LLC

  • Urgent Care Clinic/Center
  • Ponte Vedra, FL
  • NPI 1407893100
  Medicare reassignment NPD
• Florida Department of Health

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD (past)
• Solantic LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1609822592
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1013983063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 BEACH BLVD",
            "address_2": "SUIT 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247205",
            "telephone_number": "904-330-0524",
            "fax_number": "904-647-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13770 BEACH BLVD",
            "address_2": "SUIT 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247205",
            "telephone_number": "904-330-0524",
            "fax_number": "904-647-9491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6639 Southpoint Pkwy Ste 108",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168042",
            "country_code": "US",
            "telephone_number": "904-438-7640 x216",
            "fax_number": "904-438-7656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHATA",
        "first_name": "GHASSAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME0026102",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0026102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099154500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shahyar Gharacholou, MD
• Bharatsinh M Gharia, M.D.
• Hetavi Gharia, MD
• Yosef Gharzuzi, MSN, ARNP
• Rod Ghassemzadeh, M.D.
• Muhammad A Ghazi, M.D.
• Salim Ghazi, MD
• Margaret Ghee, MED
• Bianca Gheller
• Robert Gherman, DMD

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.