NPIMap

Individual provider Active NPI

Amit K Chakravarty, MD

  • Pulmonary Disease Physician
  • Jacksonville, FL
National Provider Identifier
1154352326
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME0053176 Issued in FL
Practice address
8075 Gate Pkwy W
Suite 304
Jacksonville, FL 32216-3684
Phone
(904) 739-6666
Fax
(904) 739-1009
NPI assigned
Jul 6, 2006
Last updated
Aug 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME0053176 FL Primary

Addresses

Primary practice location

8075 Gate Pkwy W
Suite 304
Jacksonville, FL 32216-3684

Mailing address

PO Box 56917
Jacksonville, FL 32241-6917
Phone (904) 739-6666

Other identifiers 4

IdentifierTypeStateIssuer
254907700MedicaidFL
44730OtherFLBCBSFL
P00367696OtherFLRAIL ROAD MEDICARE
290011203OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061003000057 FL Practitioner - Internal MedicinePractitioner - Pulmonary Disease 7618972316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8075 Gate Pkwy W
Suite 304
Jacksonville, FL 32216-3685
Phone (904) 296-0296

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0053176FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Critical Care Consultants of Jacksonville PL Pulmonary Disease CurrentSince Oct 23, 2006 Accepting new patients
Critical Care of N Jacksonville, PA Pulmonary Disease Past Accepting new patients

Locations

8075 Gate Pkwy W
Ste 304
Jacksonville, FL 32216
Phone (904) 296-0296

6817 Southpoint Pkwy
Ste 1804
Jacksonville, FL 32216
Phone (904) 296-0296

Organizations & group practices 2

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1154352326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56917",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322416917",
            "telephone_number": "904-739-6666",
            "fax_number": "904-739-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 GATE PKWY W",
            "address_2": "SUITE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163684",
            "telephone_number": "904-739-6666",
            "fax_number": "904-739-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRAVARTY",
        "first_name": "AMIT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME0053176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254907700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "44730",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00367696",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "290011203",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.