NPIMap

Individual provider Active NPI

Jonathan Dychko

  • Internal Medicine Physician
  • Sun City Center, FL
National Provider Identifier
1063972420
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME154693 Issued in FL
Practice address
819 Cypress Village Blvd
Sun City Center, FL 33573-6834
Phone
(813) 922-2660
Fax
(833) 784-1539
NPI assigned
Mar 21, 2019
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME154693 FL Primary

Addresses

Primary practice location

819 Cypress Village Blvd
Sun City Center, FL 33573-6834

Mailing address

819 Cypress Village Blvd
Sun City Center, FL 33573-6834
Phone (813) 922-2660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524001115 FL Practitioner - Internal Medicine 2860729753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Home Primary Care LLCGroup PAC ID 6204213614, 7 clinicians

Practice addresses (Care Compare)

819 Cypress Village Blvd
Sun City Center, FL 33573-6834
Phone (813) 922-2660

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Home Primary Care LLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Palm Garden of Sun City Center LLC PastSince Aug 1, 2023 Accepting new patients

Locations

819 Cypress Village Blvd
Sun City Ctr, FL 33573
Phone (813) 634-5858

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26544/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jonathan.dychko.1@26544.direct.athenahealth.com
  • Direct secure messaging: jonathan.dychko@hca4.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Palm Garden of Sun City LLCSun City Center, FL, CCN 105736 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2023
Aug 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1063972420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 CYPRESS VILLAGE BLVD",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736834",
            "telephone_number": "813-922-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 CYPRESS VILLAGE BLVD",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736834",
            "telephone_number": "813-922-2660",
            "fax_number": "833-784-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCHKO",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME154693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

Verify at the official NPI Registry.