NPIMap

Organization Active NPI

University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1144276452
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.
Practice address
653 W 8TH St
University of Florida Jacksonville Physicians, Inc.
Jacksonville, FL 32209-6511
Phone
(904) 244-3500
Fax
(904) 244-3592
NPI assigned
May 26, 2006
Last updated
Oct 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Authorized official

Name
Dr. Pradeep V. Kadambi, MDNPI 1992866727
Title
Ceo
Phone
(904) 383-1013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU
Anesthesiology Physician 207L00000X FL
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU
Pediatrics Physician 208000000X NU
Neurology Physician 2084N0400X NU
Psychiatry Physician 2084P0800X NU
Diagnostic Radiology Physician 2085R0202X NU
Surgery Physician 208600000X NU
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

653 W 8TH St
University of Florida Jacksonville Physicians, Inc.
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20040128000786 FL Part B Supplier - Clinic/Group Practice 9133025869 Receives reassigned benefits from 1,545 practitioners
17 other NPIs on this enrollment
O20040204000616 FL Part B Supplier - Clinic/Group Practice 9133025869 Receives reassigned benefits from 633 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Jacksonville Beach, FL; Macclenny, FL; Orange Park, FL; Ponte Vedra Beach, FL; Winter Haven, FL; Yulee, FL
O20040209000696 GA Part B Supplier - Clinic/Group Practice 9133025869 Receives reassigned benefits from 44 practitioners
Practice locations: Folkston, GA; Kingsland, GA; St Mary's, GA; Waycross, GA
O20051221000986 FL Part B Supplier - Clinic/Group Practice 9133025869 Receives reassigned benefits from 46 practitioners
1 other NPI on this enrollment
Practice locations: Jacksonville, FL
O20080512000528 FL Part B Supplier - Clinic/Group Practice 9133025869 Receives reassigned benefits from 23 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL
O20211111002836 GA Part A Provider - Rural Health Clinic 9133025869 Practice locations: Saint Marys, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144276452. Details of each certification follow.

Rural health clinic certification: CCN 118918

Legal name
UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 12, 2022
Last certification
Apr 12, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 17, 1978 in FL
Enrollment address
51 Lindsey LN
Saint Marys, GA 31558-1636

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory

Locations

11481 Old Saint Augustine Rd
Ste 101
Jacksonville, FL 32258
Phone (904) 633-0210

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

2777 University Blvd W
Ste 26
Jacksonville, FL 32217
Phone (904) 633-0475

3465 Village Center Dr
Jacksonville, FL 32206
Phone (904) 355-1893

5614 San Jose Blvd
Jacksonville, FL 32207
Phone (904) 633-0475

8274 Bayberry Rd
Jacksonville, FL 32256
Phone (904) 633-0800

841 Prudential Dr
Ste 140
Jacksonville, FL 32207
Phone (904) 346-0394

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly C Jones Individual W-2 Managing Employee Dec 18, 2023
Pradeep V Kadambi Individual Corporate OfficerCeo Nov 30, 2017 100%
W-2 Managing Employee Nov 30, 2017
University of Florida Jacksonville Physicians, Inc. Organization, Jacksonville, FL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 3, 2014 100%

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1,803

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 1,803

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1144276452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3660",
            "fax_number": "904-244-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST",
            "address_2": "UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3500",
            "fax_number": "904-244-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-10-28",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "KADAMBI",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-383-1013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.