Individual provider Active NPI

Krishnan Ravindran, MD

  • Neurological Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1053872739
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
ME151705 Issued in FL
Practice address
836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340
Phone
(904) 388-6518
Fax
(904) 384-1005
NPI assigned
Mar 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X ME151705 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340

Mailing address

PO Box 746647
Atlanta, GA 30374-6647
Phone (904) 202-2092

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kravindran567269@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260611001743 FL Practitioner - Neurosurgery 5092136135

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lyerly Baptist IncGroup PAC ID 9830112226, 72 clinicians

Practice addresses (Care Compare)

836 Prudential Dr
Suite 1400
Jacksonville, FL 32207-8340
Phone (904) 388-6518

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME151705FLMDNeurological Surgery Physician

Interoperability endpoints

  • Direct secure messaging: kravindran567269@ehrdirect.mayoclinicmsg.org

Organizations & group practices 1

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 2

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1053872739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746647",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746647",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078340",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINDRAN",
        "first_name": "KRISHNAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "FL",
            "license": "ME151705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kravindran567269@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

Verify at the official NPI Registry.