Individual provider Active NPI

Faiyaaz Mustansir Jhaveri, MD

  • Urology Physician
  • Davenport, FL
National Provider Identifier
1134138019
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME0080612 Issued in FL
Practice address
105 Park Place Blvd Ste a
Davenport, FL 33837-6870
Phone
(863) 419-2165
Fax
(863) 419-2166
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME0080612 FL Primary

Addresses

Primary practice location

105 Park Place Blvd Ste a
Davenport, FL 33837-6870

Mailing address

105 Park Place Blvd Ste a
Davenport, FL 33837-6870
Phone (863) 419-2165

Other identifiers 4

IdentifierTypeStateIssuer
217235OtherFLAMERIGROUP
340018541OtherFLRAILROAD MEDICARE
164139OtherFLSTAYWELL
35713OtherFLBCBS

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
I20101007000573 FL Practitioner - UrologyPractitioner - Surgical Oncology 8921290008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: Surgical Oncology
Education
Oregon Health Sciences University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0080612FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 13, 2021 Accepting new patients
Florida Hospital Physician Group Inc CurrentSince Jul 1, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 13, 2021 Accepting new patients

Locations

105 Park Place Blvd
Ste A
Davenport, FL 33837
Phone (863) 419-2156

2217 North Blvd W
Davenport, FL 33837
Phone (863) 421-3456

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: fjhaveri57820@adventhealth.direct-ci.com

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

Hospital & facility affiliations 5

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1134138019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PARK PLACE BLVD STE A",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376870",
            "telephone_number": "863-419-2165",
            "fax_number": "863-419-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PARK PLACE BLVD STE A",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376870",
            "telephone_number": "863-419-2165",
            "fax_number": "863-419-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JHAVERI",
        "first_name": "FAIYAAZ",
        "middle_name": "MUSTANSIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME0080612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "217235",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340018541",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL",
            "identifier": "164139",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35713",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.