Jacksonville Nephrology PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

ME91566 Issued in FL

Legal business name

JACKSONVILLE NEPHROLOGY PA

Practice address

13241 Bartram Park Blvd Unit 301
Jacksonville, FL 32258-5236

Phone

(904) 260-9898

Fax

(904) 260-9891

NPI assigned

Aug 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Sandeep Munjal, MD, MBANPI 1588687735

Title

President

Phone

(904) 260-9898

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ACHFAA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandeep Munjal, MD

  • Nephrology Physician
  • Jacksonville, FL
  • NPI 1588687735
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1043468416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585236",
            "telephone_number": "904-260-9898",
            "fax_number": "904-260-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585236",
            "telephone_number": "904-260-9898",
            "fax_number": "904-260-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE NEPHROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-28",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "MUNJAL",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-260-9898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME91566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jacksonville Oral Surgery PLLC
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• Nephrology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.