Pranav Reddy Bommineni, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

UO8649 Issued in FL

Practice address

1 Shircliff Way
Jacksonville, FL 32204-4748

Phone

(904) 308-7000

NPI assigned

Mar 31, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Emergency Medicine

Education

Liberty Univ College of Osteopathic Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pranav.bommineni@hca5.eclinicaldirectplus.com

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.

• Cep America, LLC

  • Emergency Medicine Physician
  • Miramar Beach, FL
  • NPI 1295442614

  FL

  Medicare reassignment Care Compare group
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946

  Emergency Medicine

  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1770345266

  Emergency Medicine

  NPD

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1093455685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Kingsley Ave",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735148",
            "country_code": "US",
            "telephone_number": "904-639-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOMMINENI",
        "first_name": "PRANAV",
        "middle_name": "REDDY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "UO8649",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bolt Behavior Services
• Kimberly J Bolton
• Mydris Boltze
• James C Boman, MD
• James Stanley Bomhard, MD
• Bomtempo Wellness LLC
• Alex Bonamy
• Casey Renee Bonaquist, D.O.
• Bond With Love LLC
• Elizabeth Bond, M.S., CF-SLP

• All providers in Jacksonville, FL
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.