Individual provider Active NPI

Naimisha Patel Dodani, PA-C

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1104269034
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102067 Issued in FL
Practice address
2 Shircliff Way Ste 800
Jacksonville, FL 32204-4758
Phone
(904) 388-2619
Fax
(904) 388-0240
NPI assigned
Apr 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102067 FL Primary

Addresses

Primary practice location

2 Shircliff Way Ste 800
Jacksonville, FL 32204-4758

Mailing address

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

Other practice location 1

836 Prudential Dr
Suite 1700B
Jacksonville, FL 32207-8334
Phone (904) 398-0125

Other identifiers 3

IdentifierTypeStateIssuer
008715500MedicaidFL
Y0H0COtherFLFL BLUE
Q00001696OtherFLMEDICARE RAILROAD

Other names 1

  • Namisha Patel Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130626000613 FL Practitioner - Physician Assistant 0143469965 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9102067FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Specialists, LLC CurrentSince Jul 31, 2017 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Aug 31, 2015 Accepting new patients
Cancer Specialists, LLC CurrentSince Jul 31, 2017 Accepting new patients
Baptist Cardiology, Inc. Past Accepting new patients
Washington Metropolitan Practice Plan Past Accepting new patients

Locations

2 Shircliff Way
Ste 400
Jacksonville, FL 32204
Phone (904) 308-4000

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

4205 Belfort Rd
Ste 2069
Jacksonville, FL 32216
Phone (904) 296-0278

2 Shircliff Way
Ste 300
Jacksonville, FL 32204
Phone (904) 308-7959

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

2 Shircliff Way
Ste 800
Jacksonville, FL 32204
Phone (904) 388-2619

1658 St Vincents Way
Ste 310
Middleburg, FL 32068
Phone (904) 308-2006

1658 St Vincents Way
Ste 300
Middleburg, FL 32068
Phone (904) 276-5100

300 Saint Elizabeth Way
Ste 110
St Johns, FL 32259
Phone (904) 691-9100

Interoperability endpoints

  • Direct secure messaging: namisha.dodani.1@8967.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1104269034",
    "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": "2 SHIRCLIFF WAY STE 800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044758",
            "telephone_number": "904-388-2619",
            "fax_number": "904-388-0240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 Prudential Dr",
            "address_2": "Suite 1700B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078334",
            "country_code": "US",
            "telephone_number": "904-398-0125",
            "fax_number": "904-725-1622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODANI",
        "first_name": "NAIMISHA",
        "middle_name": "PATEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008715500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "Y0H0C",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "Q00001696",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAMISHA",
            "last_name": "PATEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.