Individual provider Active NPI

Gaurav Trikha, MD

  • Hematology & Oncology Physician
  • St Augustine, FL
National Provider Identifier
1043485956
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME105077 Issued in FL
Practice address
121 Whitehall Dr
St Augustine, FL 32086-5266
Phone
(904) 825-4500
Fax
(904) 825-3672
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME105077 FL
Infectious Disease Physician 207RI0200X ME105077 FL
Hematology & Oncology Physician 207RH0003X ME105077 FL Primary

Addresses

Primary practice location

121 Whitehall Dr
St Augustine, FL 32086-5266

Mailing address

7015 A C Skinner Pkwy Ste 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 273-9804

Other identifiers 4

IdentifierTypeStateIssuer
P01937394OtherFLRR MEDICARE
001491500MedicaidFL
146AUOtherFLFLORIDA BLUE
CP887YOtherFLMEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100109000139 FL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8224179460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cancer Specialists LLCGroup PAC ID 9133377948, 46 clinicians

Practice addresses (Care Compare)

121 Whitehall Dr
St Augustine, FL 32086-5266
Phone (904) 825-4500

159 N 3Rd St E
Cancer Specialist of North Florida
Macclenny, FL 32063-2103
Phone (904) 388-2619

5742 Booth Rd
Suite a
Jacksonville, FL 32207-5982
Phone (904) 739-7779

700 3Rd St
Suite 302
Neptune Beach, FL 32266-5082
Phone (904) 997-3800

80 Pinnacles Dr
Suite 700
Palm Coast, FL 32164-2915
Phone (386) 387-8500

Hospital & facility affiliations

  • Flagler Home Care LLC Home health agency, Saint Augustine, FL, CCN 108211
  • Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
  • Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Specialists, LLC Hematology & Oncology CurrentSince Jul 3, 2017 Accepting new patients
Cancer Specialists, LLC CurrentSince Jul 3, 2017 Accepting new patients

Locations

5742 Booth Rd
Ste A
Jacksonville, FL 32207
Phone (904) 739-7779

7015 A C Skinner Pkwy
Ste 1
Jacksonville, FL 32256
Phone (904) 363-2113

159 N 3rd St
Ste E
Macclenny, FL 32063
Phone (904) 388-2619

121 Whitehall Dr
St Augustine, FL 32086
Phone (904) 519-2738

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1043485956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WHITEHALL DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865266",
            "telephone_number": "904-825-4500",
            "fax_number": "904-825-3672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-273-9804",
            "fax_number": "352-392-6451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIKHA",
        "first_name": "GAURAV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME105077",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME105077",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME105077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01937394",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001491500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "146AU",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CP887Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.