Active NPI
Sushilkumar Kadu Sonavane, MD
- Diagnostic Radiology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME139396
- Practice address
- 4500 San Pablo Rd S
Jacksonville, FL 32224-1865 - Phone
- (904) 953-2000
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 2010007603 | MO | |
| Diagnostic Radiology Physician | 2085R0202X | L.3416SP | AL | |
| Diagnostic Radiology Physician | 2085R0202X | ME139396 | FL | Primary |
Addresses
Primary practice location
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Mailing address
PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701
Other practice location 1
2000 6th Ave S
Birmingham, AL 35233-2110
Phone (205) 801-8000
Other identifiers 21
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051117669 | Other | AL | BCBS |
| 051117671 | Other | AL | BCBS |
| 129732 | Medicaid | AL | |
| 129751 | Medicaid | AL | |
| 051117672 | Other | AL | BCBS |
| 129730 | Medicaid | AL | |
| 129734 | Medicaid | AL | |
| 129746 | Medicaid | AL | |
| 051117667 | Other | AL | BCBS |
| 051117673 | Other | AL | BCBS |
| 129724 | Medicaid | AL | |
| 129738 | Medicaid | AL | |
| 051117678 | Other | AL | BCBS |
| 051117679 | Other | AL | BCBS |
| 129728 | Medicaid | AL | |
| 051117668 | Other | AL | BCBS |
| 051117676 | Other | AL | BCBS |
| 051117674 | Other | AL | BCBS |
| 129743 | Medicaid | AL | |
| 07135395 | Medicaid | MS | |
| 129750 | Medicaid | AL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ssonavane604820@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Hospital & facility affiliations
- Mayo Clinic
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.24 of 100
- Quality
- 74.85
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.62
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L.3416SP | AL | MD | Diagnostic Radiology Physician |
| ME139396 | FL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Jacksonville | Current | Accepting new patients | |
| Mayo Clinic Jacksonville | Current | Accepting new patients |
Locations
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815
Interoperability endpoints
- ssonavane604820@ehrdirect.mayoclinicmsg.org
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1790772317
-
- Home Infusion Therapy Pharmacy
- Jacksonville, FL
- NPI 1003510116
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1891782470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599004800000",
"number": "1033313465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55310",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352555310",
"telephone_number": "205-731-9701",
"fax_number": "205-297-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
}
],
"practiceLocations": [
{
"address_1": "2000 6th Ave S",
"address_purpose": "LOCATION",
"city": "Birmingham",
"state": "AL",
"postal_code": "352332110",
"country_code": "US",
"telephone_number": "205-801-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SONAVANE",
"first_name": "SUSHILKUMAR",
"middle_name": "KADU",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-11",
"last_updated": "2020-09-02",
"certification_date": "2020-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2010007603",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AL",
"license": "L.3416SP",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME139396",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117669",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117671",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129732",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129751",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117672",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129730",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129734",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129746",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117667",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117673",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129724",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129738",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117678",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117679",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129728",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117668",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117676",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051117674",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129743",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07135395",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129750",
"state": "AL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ssonavane604820@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "4500 San Pablo Rd S",
"city": "Jacksonville",
"state": "FL",
"country_code": "US",
"postal_code": "322241865",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.