Individual provider Active NPI

Sandeep Raja Sasidharan, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1083268387
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
ME173180 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-4075
Fax
(904) 244-5047
NPI assigned
Jul 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME173180 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-4075

Other practice location 1

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-6208

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
I20250730001475 FL Practitioner - Critical Care (Intensivists) 5799292009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc Critical Care Medicine CurrentSince Jul 14, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 14, 2025 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

653 W 8th St
Fl 3
Jacksonville, FL 32209
Phone (904) 244-3689

15255 Max Leggett Pkwy
Ste 3900
Jacksonville, FL 32218
Phone (352) 265-8940

10475 Centurion Pkwy N
Ste 201
Jacksonville, FL 32256
Phone 90422333213118

Organizations & group practices 3

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1083268387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-4075",
            "fax_number": "904-244-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4075",
            "fax_number": "904-244-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Summer St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081216",
            "country_code": "US",
            "telephone_number": "508-363-6208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SASIDHARAN",
        "first_name": "SANDEEP",
        "middle_name": "RAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME173180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.